Summary: One of the new studies shows that TMS, a non-invasive and safe method, may be used to prevent chronic pain. It may be used when individuals are at risk of developing chronic pain, like those undergoing planned surgery or dental procedures.
In one of the first of its kind studies, researchers demonstrated that a short course of non-invasive brain stimulation before a painful event like a surgical procedure may considerably reduce the risk of someone developing chronic pain later.
This is quite an unusual approach. Although doctors may sometimes use certain painkillers beforehand, but they do not use interventions to reduce pain risk beforehand. Moreover, this intervention is not just about reducing pain sensation, like that with painkillers, but rather about preventing episodes altogether. With this approach, even if pain occurs, it is not that severe, and there are significantly reduced chances of it becoming chronic. Since this whole effect is achieved by a non-invasive method, it is also safe.
Using transcranial magnetic stimulation or TMS for pain management is not uncommon. This method is used to manage many other issues like depression, phobias, and memory-related issues. Chronic pain specialists often employ advanced tools like TMS to address pain at its root.
However, the latest study by the University of New South Wales (UNSW) and Neuroscience Research Australia (NeuRA) has demonstrated that TMS may be suitable for preventing chronic pain and may be used prior to pain onset.
The study found that a short course of five sessions was enough to reduce the risk of chronic pain in patients who were likely to develop the issue after a specific procedure.
Researchers say that they want to change the way pain is managed. Generally, doctors would treat pain when it occurs, or sometimes they might use specific treatment methods only when the pain has consolidated or become chronic. However, a proactive approach to pain is still uncommon. Nonetheless, such an approach may be used in many instances, such as before planned surgical or dental procedures.
For those seeking advanced solutions, interventional pain management in St. Louis has been instrumental in exploring cutting-edge techniques like TMS. The good thing about TMS is its excellent safety profile, making it perfectly suited for pain prevention. It involves applying short magnetic pulses to stimulate nerves, brain neurons, or specific brain parts by applying special coils against the scalp. Thus, the procedure is entirely non-invasive and pain-free. The procedure is so simple to carry out that initially, many researchers doubted its efficacy, though now it is proven to work, providing relief in many conditions.
In this new study, researchers enrolled 41 healthy adults and divided them into two groups, with one group receiving TMS and another sham treatment. They were given TMS or sham treatment in five sessions, 26 days before the painful intervention.
The researchers also measured the activity of specific brain areas at baseline and after TMS. They found that TMS could alter brain activity in specific brain areas associated with pain, memory, arousal, and motor functions.
After all the participants received TMS or sham treatment, they were injected with nerve growth factor in their jaw. Though this injection is safe, but it is known to cause pain.
Researchers found that those who received real TMS experienced much less pain compared to those who received sham treatment. This confirms that TMS works as a preventive measure.
Those who received TMS reported much lower jaw pain and did not report significant jaw mobility issues. Moreover, researchers found that the difference was especially greater among the two groups at three-week intervals, showing the ability of TMS to lower the risk of chronic pain.
Researchers say that they are really excited about these findings. Science has been using TMS for years to manage chronic pain. However, managing chronic pain is quite difficult as it is challenging to reverse maladaptive brain activity. In short, it is challenging to reverse a consolidated pain. Thus, more attention must be given to pain prevention rather than solely focusing on pain treatment.
Investigators say that they can now build on this study. They can explore different methods of TMS application and its role in chronic pain prevention. They may experiment with different methodologies. And, of course, more extensive studies might be done to define the role of such preventive measures fully. Nonetheless, this study did confirm that preventive measures are an option to stop chronic pain before it begins.
Source:
Chowdhury, N. S., Taseen, K. J., Chiang, A. K., Chang, W.-J., Millard, S. K., Seminowicz, D. A., & Schabrun, S. M. (2022). A 5-day course of repetitive transcranial magnetic stimulation before pain onset ameliorates future pain and increases sensorimotor peak alpha frequency. PAIN, 10.1097/j.pain.0000000000003484. https://doi.org/10.1097/j.pain.0000000000003484
