UH3 Project: Fibromyalgia TENS in Physical Therapy Study (FM-TIPS)
Overview
Principal Investigators:
Sponsoring Institution: University of Iowa
Collaborators:
- Advanced Physical Therapy and Sports Medicine
- Big Stone Physical Therapy
- Genesis Healthcare Systems
- Kepros Physical Therapy and Performance
- Rock Valley Physical Therapy
- University of Illinois Chicago
NIH Institute Providing Oversight: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Program Official: Charles Washabaugh, PhD (NIAMS)
Project Scientist: Joe Bonner, PhD (National Institute of Child Health and Human Development [NICHD]/National Center for Medical Rehabilitation Research [NCMRR])
ClinicalTrials.gov Identifier: NCT04683042
Trial Status: Enrolling
Trial Summary
Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, tenderness, and stiffness associated with fatigue and sleep disturbance. The goal of reducing opioid use in patients with chronic pain requires that proven nonpharmacologic treatments are applied in clinical practice. A recently completed trial conclusively demonstrated the efficacy of transcutaneous electrical nerve stimulator (TENS) for reducing musculoskeletal pain. While physical therapists are trained in the use of TENS, it is underused in clinical practice. FM-TIPS is an embedded pragmatic trial comparing the effectiveness of physical therapy with or without the addition of TENS for patients with fibromyalgia within physical therapy clinics. The aims of the trial are to demonstrate the feasibility of adding TENS to the treatment of patients with fibromyalgia in a real-world practice setting and to determine if the addition of TENS reduces pain, increases adherence to physical therapy, and allows patients to reach their specific functional goals with less medication use. FM-TIPS will address the critical need for strategies that implement effective nonpharmacologic treatments for fibromyalgia. Successful completion of this trial will provide generalizable effectiveness data for referring providers, physical therapists, and insurers and will inform future pragmatic trials of nonpharmacologic treatments conducted in physical therapy practices.
Data and Resource Sharing
- FM TIPS-2021-UH3 Follow-up
FM TIPS-Ethics and Regulatory UH3 Follow-up
- FM TIPS-UG3 Minutes and Supplement_C
FM TIPS Ethics and Regulatory Discussion
Featured Interviews
Co–principal investigators Dr. Kathleen Sluka and Dr. Leslie Crofford discuss FM-TIPS.
News and Interviews
- News_In FM-TIPS Pragmatic Trial, Adding TENS to Physical Therapy Improved Fibromyalgia Pain
April 2, 2026: In FM-TIPS Pragmatic Trial, Adding TENS to Physical Therapy Improved Fibromyalgia Pain
- News_A Year of Trial Results and Innovations From the NIH Pragmatic Trials Collaboratory
December 15, 2025: A Year of Trial Results and Innovations From the NIH Pragmatic Trials Collaboratory
- News_Results From the FM-TIPS Trial, in This Week’s Rethinking Clinical Trials Grand Rounds
December 3, 2025: Results From the FM-TIPS Trial, in This Week’s Rethinking Clinical Trials Grand Rounds
- News_Community Engagement Strategies Boost Rural Enrollment in FM-TIPS Fibromyalgia Trial
December 2, 2025: Community Engagement Strategies Boost Rural Enrollment in FM-TIPS Fibromyalgia Trial
- News_In This Week’s PCT Grand Rounds, Community Engagement Methods in the FM-TIPS Trial
January 8, 2025: In This Week’s PCT Grand Rounds, Community Engagement Methods in the FM-TIPS Trial
- News_A Year of Innovations and Insights From the NIH Pragmatic Trials Collaboratory
December 12, 2024: A Year of Innovations and Insights From the NIH Pragmatic Trials Collaboratory
- News_Hybrid Methods Improve Collection of Patient-Reported Outcome Measures in Rural and Underserved Populations
November 26, 2024: Hybrid Methods Improve Collection of Patient-Reported Outcome Measures in Rural and Underserved Populations
- News_NIH Collaboratory Trial Investigators Share Lessons From Using Electronic Health Records in Pragmatic Trials
November 25, 2024: NIH Collaboratory Trial Investigators Share Lessons From Using Electronic Health Records in Pragmatic Trials
- News_Case Study Describes a Reassessment of Sample Size in an Ongoing Cluster Randomized Trial
October 15, 2024: Case Study Describes a Reassessment of Sample Size in an Ongoing Cluster Randomized Trial
- News_Pragmatic Trials Researchers Share Lessons From Collecting Patient-Reported Outcomes in the Electronic Health Record
January 8, 2024: Pragmatic Trials Researchers Share Lessons From Collecting Patient-Reported Outcomes in the Electronic Health Record
Publications
- Dailey et al JAMA Netw Open 2026
FM-TIPS Main Outcome Paper
- Vance et al J Clin Transl Sci 2025
Community engagement strategies improve recruitment and enrollment in a pragmatic clinical trial
- Adams et al Pain Med 2025
Building community through data: the value of a researcher driven open science ecosystem
- Fleagle et al J Pain 2024
Minimal clinically important change of movement pain in musculoskeletal pain conditions
- Liebano et al Trials 2024
Effects of transcutaneous electrical nerve stimulation on pain, function, and descending inhibition in people with non-specific chronic low-back pain: a study protocol for a randomized crossover trial
- Berardi et al J Pain 2024
Influence of transcutaneous electrical nerve stimulation (TENS) on pressure pain thresholds and conditioned pain modulation in a randomized controlled trial in women with fibromyalgia
- Curtis et al Contemp Clin Trials 2025
Monitoring in pragmatic trials lessons from the NIH Pragmatic Trials Collaboratory
- Marsolo et al Contemp Clin Trials 2024
Impact of electronic health record updates and changes on the delivery and monitoring of interventions in embedded pragmatic clinical trials
- Cheville et al Appl Clin Inform 2024
Collection of patient-reported outcome measures in rural and underserved populations
- Butera et al J Pain 2024
Through the lens of movement-evoked pain: a theoretical framework of the "pain-movement interface" to guide research and clinical care for musculoskeletal pain conditions
- Zigler et al Contemp Clin Trials 2023
Collecting patient-reported outcome measures in the electronic health record: Lessons from the NIH Pragmatic Trials Collaboratory
- Boyd et al J Am Med Inform Assoc 2023
Potential bias and lack of generalizability in electronic health record data: reflections on health equity from the National Institutes of Health Pragmatic Trials Collaboratory
- Staman et al Contemp Clin Trials 2023
Intervention delivery for embedded pragmatic clinical trials: Development of a tool to measure complexity
- Vance et al Medicina (Kaunas) 2022
Using TENS for pain control: update on the state of the evidence
- Post et al Phys Ther 2022
FM-TIPS Study Design Paper
- Shraim et al Pain 2022
Features and methods to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system: a Delphi expert consensus study
- Richesson et al J Am Med Inform Assoc 2021
Enhancing the use of EHR systems for pragmatic embedded research: lessons from the NIH Health Care Systems Research Collaboratory
- Raja et al Pain 2020
The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises
- FM-TIPS Study Snapshot
FM-TIPS Study Snapshot
- Living Textbook Chapter_Which PCTs Should Have a DMC
Living Textbook Chapter: Which Pragmatic Trials Should Have a DSMB?
- Living Textbook_How Are PRO Measures Used
Living Textbook: How are PRO Measures Used?
- Living Textbook_The Embedded Pragmatic Trials Ecosystem
Living Textbook: The Embedded Pragmatic Clinical Trial Ecosystem
Presentations
- 00_Harrington_combined_FINAL
Building Relationships With Communities in Pragmatic Research
- 03_Crofford_FM TIPS_Data_Final
2024 NIH Workshop Session 3 Crofford
- SC-Mtg-2024-Day2-Marsolo
Data Extraction and Quality Challenges/ Lessons Learned
- 2023 AAHPM Upstreaming PC_ ED Opportunities Tan 23Mar2023.pptx
Upstreaming Palliative Care: Emergency Department Opportunities
- SC-Mtg-2023-Day2-Sluka
Kathleen Sluka FM-TIPS Presentation 2023 Steering Committee Meeting
- SC-Mtg-2022-Day-2-Sluka
FM-TIPS Presentation at 2022 Steering Committee Meeting
- GR-Video-07-24-20
TENS in Fibromyalgia: From Fundamental Neurobiology to Pragmatic Trial (GR Video 2020)
- GR-Slides-07-24-20
TENS in Fibromyalgia: From Fundamental Neurobiology to Pragmatic Trial (GR Slides 2020)
- FM TIPS_Sluka_Crofford_PRISM Kickoff_FINAL1
FM-TIPS Presentation at PRISM Kickoff Meeting