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 people are at risk of chronic pain, like those facing planned surgery or dental work.
This is one of the first studies of its kind. Researchers showed that a short course of non-invasive brain stimulation before a painful event, like surgery, may sharply cut the risk of chronic pain later.
This is an unusual approach. Doctors sometimes give painkillers ahead of time. But they do not use treatments to lower pain risk ahead of time. And this is not just about dulling pain, the way painkillers do. It is about stopping pain before it starts. Even if pain does show up, it is not as bad, and it is significantly less likely to turn chronic. Since it all comes from a non-invasive method, it is also safe.
Using transcranial magnetic stimulation, or TMS, for pain is not unusual. Doctors also use it for depression, phobias, and memory problems. Chronic pain specialists often use advanced tools like TMS to treat pain at its root.
Now a new study by the University of New South Wales (UNSW) and Neuroscience Research Australia (NeuRA) shows more. TMS may help prevent chronic pain when used before the pain starts.
The study found that a short course of five sessions was enough. It cut the risk of chronic pain in patients likely to get it after a given procedure.
The researchers want to change how pain is treated. Most doctors treat pain once it shows up. Some wait to use certain treatments until the pain has set in or turned chronic. Getting ahead of pain is still rare. Yet it could work in many cases, such as before planned surgery or dental work.
For those seeking advanced solutions, interventional pain management in St. Louis has helped explore new tools like TMS. The big plus of TMS is its excellent safety record. That makes it a perfect fit for preventing pain. A special coil is held against the scalp. It sends short magnetic pulses that wake up nerves, brain cells, or certain parts of the brain. So the procedure is fully non-invasive and pain-free. It is so simple that many researchers first doubted it worked. Now it is proven, and it brings relief in many conditions.
In this new study, researchers signed up 41 healthy adults and split them into two groups. One group got TMS and the other got a sham treatment. They got TMS or sham treatment in five sessions, 26 days before the painful step.
The researchers also measured activity in certain brain areas at the start and after TMS. TMS could change activity in brain areas tied to pain, memory, arousal, and movement.
After everyone got TMS or sham treatment, they got a nerve growth factor injection in the jaw. Though this injection is safe, it is known to cause pain.
Those who got real TMS felt much less pain than those who got sham treatment. This shows that TMS works to prevent pain.
Those who got TMS had much less jaw pain and did not report significant trouble moving the jaw. The gap between the two groups was largest at three weeks. That shows TMS can lower the risk of chronic pain.
The researchers are excited by these results. TMS has been used for years to manage chronic pain. But chronic pain is hard to treat, because maladaptive (faulty) brain activity is hard to undo. In short, pain that has set in is hard to reverse. So we must put more effort into preventing pain, not just treating it.
The team can now build on this study. They can test different ways of giving TMS and its role in preventing chronic pain. They may try other methods too. Larger studies may be done to fully define the role of prevention. Still, this study showed that prevention is a real option to stop chronic pain before it begins.
Frequently asked questions
Can TMS be used to treat chronic pain?
Yes. TMS has been used for years to manage chronic pain. It is also used for depression, phobias and memory problems. A study by UNSW and NeuRA went further. Five TMS sessions before a painful event lowered the risk of pain turning chronic. That makes it useful before planned surgery or dental work, not only after pain sets in.
How painful is TMS therapy?
TMS is non-invasive and pain-free. A special coil held against the scalp sends short magnetic pulses. There are no needles or cuts. It has an excellent safety record. That is why researchers see it as a good fit for preventing pain, not just treating it.
How does TMS work?
TMS applies short magnetic pulses through a coil placed against the scalp. The pulses stimulate nerves, brain neurons or specific parts of the brain. In the UNSW and NeuRA study, TMS changed activity in brain areas tied to pain, memory, arousal and movement. People who got it felt much less pain after a painful jaw injection than those given a sham treatment.
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
Dr. Gurpreet Singh Padda, MD, MBA, MHP
