This 44-year-old patient, who used to do a lot of athletics and dance with soupleness, has for 2 years presented symptoms of fibromyalgia, with the absence of any obvious triggering factor. Since then she has progressively shown signs of stiffness in the hands, shoulders, neck, hips and back, prooving very disabling. Before the stimulation sessions began, her average daily pain threshold was about 7/10. Since, she feels tired, with a functional colopathie.

We can see she has great difficulty in raising her arms in the air, turning her neck. She cannot lean forwards. The squatting position is almost impossible (see video 1).

A classical wide Field transcranial stimulation was carried out in a classic way and a peripheral stimulation at 4 Hz on both the painful regions and on the stiff areas. After the stimulation (see video 2) there is a disappearance of the stiffness. She can raise her arms very easily. She turns her neck without any difficulty. She can bend forwards until she touches the ground with her hands and the squatting position is no longer a problem for her. After the stimulation, she was to experience a state of fatigue that worsened over a few hours, but improved the following day. In the days that followed, her pain threshold reduced significantly to around 3/10 as a daily average.


video 2

This patient therefore presents a fibromyalgia with a particularly intense stiffness that lasts throughout the day. Often, with a fibromyalgia, any stiffness usually only exists in the morning. She is very limited in all her daily activities because of this stiffness that is associated with pain. Peripheral stimulation resulted in an immediate and very important improvement of any stiffness. She indicated a decrease in pain during the following days and was, for several weeks, less tired. Constipation decreased. At the moment it is necessary to repeat the stimulation sessions every month because the symptoms gradually reappear after the third week following the stimulation session.

To illustrate the mode of stimulation used in fibromyalgia, I present you this 54-year-old patient who has had for 4 years fibromyalgia with diffused pain, in all four limbs, in her back and in her neck.

The concave circular coil is used, with its center placed on the vertex. 60 stimulations at 1 Hz at the engine threshold (see video 1).

It is stimulated with a flat circular coil with internal cooling (if possible) on the various painful points of the limbs, i.e. hips, thighs, knees, calves, ankles (see video 2), shoulders, shoulder blades and Lumbar region (see video 3), elbows, hands and also the neck (see video 4). It is usual to stimulate at 3 Hz with the intensity at the pain threshold. The internal cooling of the coil allows us to stimulate longer without heating the coil.


video 2


video 3


video 4

The patient said she felt an 80% improvement from the stimulation that lasted some two months. We must therefore repeat this type of stimulation in order to maintain its effect.

Two thirds of patients will respond significantly to this type of stimulation, that is to say with an average of at least 2 points less pain daily (oral presentation at the French Society of Rheumatology in 2014). To determine if a patient responds to this technique, at least three stimulation sessions are required at three week intervals between each session. If we don't see the 2 points less pain after these three sessions, I do not propose to continue this type of treatment. For the others, who are therefore responding to magnetic stimulation, the sessions will have to be repeated regularly with an interval varying from one and a half to three months in order to maintain the effects of the stimulation. For these other patients, the decrease in the average daily pain threshold is usually between 3 and 5 out of ten. Repeating the sessions can progressively lengthen this interval. On the other hand, most patients experience a significant effect on their stiffness from this stimulation. There is also a frequent decrease in headaches. When functional colopathie exists, there is often an improvement.

This patient presents a diffused fibromyalgia over four years. She feels like she has a carcass around her that make any movement steep and very difficult. This stiffness is especially present in the morning. She struggles to get up from sitting in a chair and crouching (see Video 1). The hands are very stiff and she often drops objects. There is a predominant tremor on the right hand (see video 2). She has trouble writing (see video 3).

A central stimulation was carried out at 1 Hz at the engine threshold (see video 4). Then we undertook peripheral stimulations on the painful areas, especially the hips (see video 5), the thighs, the knees, the shoulders and shoulder blades, the lumbar region and the neck. In particular, we stimulated the hands (see video 6).

After the different types of stimulation, we observe the patient is much more flexible. She can easily rise from a chair and crouch repeatedly. She writes much more easily. She opens and closes her hands more easily. The trembling of the right hand has disappeared (see video 7).


video 7

It is frequently observed that, with fibromyalgia patients, any stiffness diffuses as well as pain. This stiffness leads to awkwardness. Central and peripheral stimulation can immediately have a significant effect. The effect of stimulation often has a limited duration and I have to stimulate this patient every month and a half to maintain a satisfactory clinical situation. After each stimulation session, the immediate improvement is identical.

A 51 year old patient with Fibromyalgia for the past 5 years, with no specific triggering factor.

She is experiencing diffused pain in the hips, thighs, knees and ankles. Equally, her wrists, elbows, shoulders, lumbar area and neck all hurt. The average daily pain threshold is 8/10. There exists a very large stiffness in the hands (she has trouble writing, extending and lifting arms), in the elbows and neck (video 1). Equally, there exists a functional colopathie.

After large-field central magnetic stimulation, there is some improvement of the stiffness in the hands, but very little improvement in her elbows, shoulders and neck (video 2). After peripheral stimulation at 3Hz, at the pain threshold on these different regions, immediate improvement, after 1 session, on the stiffness was very important (Video 3). The pain decreased after a few days to an average daily level of 3/10. It is necessary to repeat these stimulations every 2 months because the effect disappears after this period of time. Functional Colopathie (especially constipation) is also greatly improved by stimulation at 3Hz on the abdomen.


video 2


video 3

It is classic, in patients with fibromyalgia, to observe a morning stiffness, especially in the hands, knees and hips. Sometimes this stiffness can be permanent and disabling, with difficulty in closing the hands (where the fingers can be swollen), extending elbows and lifting arms as with this patient. Almost constantly, peripheral stimulation at 3Hz, made at the pain threshold on these regions, improves the situation.

A 54 year old patient with fibromyalgia for the past 10 years, with no specific triggering factor.

She presents diffused pain, just like the previous patient (Patiente 4). The average daily pain threshold is 6/10. There is a very large stiffness in the hands, elbows, shoulders and the neck (see video 1).

After large field central magnetic stimulation, there is no significant immediate improvement of the stiffness. After peripheral stimulation at 3Hz, at the pain threshold, on these different regions, immediate improvement, after 1 session, on the stiffness was very important (see video 2). The pain will also decrease after a few days to an average daily level of 2/10. It is necessary to repeat these stimulations every 2 months because the effect disappears after this period of time.


video 2

It is classic, in patients with fibromyalgia, to observe a morning stiffness, especially in the hands, knees and hips. Sometimes this stiffness can be permanent and disabling, with difficulty in closing the hands (where the fingers can be swollen), extending elbows and lifting arms as with this patient. Almost constantly, peripheral stimulation at 3Hz, made at the pain threshold on these regions, improves the situation.

Mostly muscular pains that have appeared gradually over 10 years with no particular triggering factor. This patient also complains of stiffness, especially at the level of the hips. He was investigated in several University Hospital Centres in Rouen and Paris. All the investigations were normal but the formal diagnosis of fibromyalgia was never made. He was placed on disability. He was previously an ardent walker, while currently his distance is very limited. He can no longer run and has trouble crouching (see video 1). He has a lot of difficulty climbing the stairs.

Large field central magnetic stimulation did not alter , in a clear way, any discomfort in walking.
Peripheral magnetic stimulation at 3Hz, using a maximum pain threshold, essentially on the lumbar regions, hips and limbs, will transform the situation.

After the stimulation, he was able to run as he had not done so in 10 years, and he could crouch up and down several times without any difficulty (see video 2). He needed to be stimulated regularly every two months to maintain the effect.


video 2

As with previous patients, peripheral magnetic stimulation is a major role in the improvement of stiffness, which with this patient was extremely disabling. The considerable improvement of the clinical situation under central and peripheral magnetic stimulation is a very strong argument in favour of a functional pathology of a fibromyalgia type. Fibromyalgia can be diagnosed with purely muscular pain, without any real joint pain.

A patient aged 35 years with fibromyalgia over the past 3 years, which occurred gradually following childbirth.

She presents diffused pain with a daily average pain threshold of 7/10. She has trouble walking to do the shopping, to take care of her child, and to undertake everyday life routine tasks. There is a very large stiffness in the hands, shoulders and the neck (see video 1). Two months before this consultation, she made a severe left sensitive motor deficit, almost completely regressive, but a left hypoesthesia and a more pronounced motor disorder at the level of the leg and foot persist. She has trouble moving her toes and in recognising the position of her big toe (see videos 2 and 3).

After large field central magnetic stimulation, there is no significant immediate improvement of the stiffness in the hands, neck and the left foot. After peripheral stimulation of these different regions, at 3Hz at the pain threshold, in a single session, immediate improvement on the stiffness was very significant. After more prolonged stimulation on the left foot, the sensitivity and the motricity of the foot will normalise itself (see video 4).


video 4

It is a classic observation, in patients with fibromyalgia, to observe a morning stiffness, especially in the hands, knees and hips. Sometimes this stiffness can be permanent and disabling, with difficulty in closing the hands (where the fingers can be swollen), lifting the arms and turning the neck, as with this patient. Almost constantly, peripheral stimulation at 3Hz, done at the pain threshold on these regions, improves the situation. Two months before this consultation, this patient made a severe left sensitive motor deficit, obviously functional (imagery was normal) with persistence of some symptoms. Peripheral magnetic stimulation allowed full recovery of the deficiency (which confirms the diagnosis of a functional neurological disorder). It will be necessary to repeat regularly every 2 or 3 months stimulation sessions to improve the fibromyalgia.