Providence VA Medical Center, Rhode Island
tDCS Studied for Low Back Pain
A noninvasive method being studied for treating depression and posttraumatic stress may offer benefits for people suffering from chronic low back pain, as well.
Transcranial direct-current stimulation, known as tDCS, works by sending a low current through electrodes, increasing or decreasing neuron activity in the area being stimulated. In this study, the technique appeared to improve pain-related disability and mood symptoms.
"This was a small study, so the results need to be replicated in larger, longer-duration studies, but there is encouraging potential here," said lead study author Dr. Timothy Mariano, a researcher with Harvard Medical School, in Boston, Mass., and the VA Rehabilitation Research and Development Service's Center for Neurorestoration and Neuro-technology, or CfNN, located at the Providence VA Medical Center in Providence, R.I.
Pain has both sensory and emotional effects, explained Dr. Frederick Burgess, former Chief of Anesthesia at the Providence VAMC, who played a major role in getting the study up and running there. Treatments for chronic pain usually focus on the sensation of pain, so there is often an over-reliance on opioid medications, which have dangerous side effects. "People with chronic pain can develop behaviors that may lead to depression and avoiding certain activities," he said. "These emotional issues are not addressed by current medications, so the focus here was on improving mood and disability symptoms without relying on painkilling medications."
Mariano's team conducted a double-blind, placebo-controlled, randomized trial including 21 patients with chronic low back pain. Some patients received active tDCS treatment, while others received simulated treatment as a placebo for comparison. Participants rated their pain before and after treatment.
After six weeks, patients in the active-treatment group showed improvement compared with those who received the placebo.
"The actual difference at six weeks was fairly modest," Mariano cautioned, "but even a small improvement in a severely impaired population without the risks of opioid medications is encouraging."
The study was funded by a Young Investigator Grant from the National Alliance for Research on Schizophrenia & Depression, CfNN, the National Institute of Mental Health, Butler Hospital, and the Brown Institute for Brain Science.