The effects of repetitive transcranial magnetic stimulation (rTMS) on chronic lower back pain

Publication Reference

Ambriz‐Tututi, M., Alvarado‐Reynoso, B., & Drucker‐Colín, R. (2016). Analgesic effect of repetitive transcranial magnetic stimulation (rTMS) in patients with chronic low back pain. Bioelectromagnetics37(8), 527-535.


Article Summary*

In this open-label, sham-controlled study, participants with chronic lower back pain were randomized to receive active rTMS (n = 44), sham (n = 12), or physical-therapy (n = 26).  In the active group high frequency rTMS (20Hz) at 95% resting motor threshold was delivered to the left M1 for 5 sessions in week 1, followed by 8 further session across the 9 months duration of the study.  After 1 week of treatment both the rTMS and physical-therapy groups demonstrated a significant reduction in pain levels, as measured on a visual analogue scale (VAS).  However, by week 3 the rTMS group showed an 80% reduction in pain levels, which was significantly greater than the pain reduction achieved in the physical-therapy group. These reductions in VAS scores were maintained across the 9 months of the study for both rTMS and physical-therapy. The sham group experienced no improvements, until receiving one week of active rTMS to differentiate a placebo effect, which led to a significant reduction in pain. Four weeks after treatment, the Short Form McGill Pain Questionnaire demonstrated that rTMS and physical-therapy were both associated with significant reductions in sensory pain and total pain scores, with rTMS also having significant reductions in affective pain scores. Further, the Short Form 36 Health Questionnaire showed that rTMS was associated with significant improvements in somatic pain, physical functioning, social functioning, and emotional role. The authors concluded that rTMS produced a prolonged relief from pain that was more effective than physical-therapy.


*For original abstract/publication see the link below.


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