Plasticity-Inducing Percutaneous Peripheral Nerve Stimulation for Treating Neck Pain: A Blinded, Randomised Clinical...

Area of Science:

• Neuroscience
• Pain Management
• Neuromodulation

Background:

• Previous animal studies demonstrated synaptic plasticity induction via percutaneous peripheral nerve stimulation (pPNS) protocols leading to hypoalgesia.
• The efficacy of these pPNS protocols in alleviating pain within a human clinical population remained uninvestigated.
• This study focused on non-specific neck pain patients.

Purpose of the Study:

• To investigate the effects of pPNS protocols on pain symptoms in individuals with non-specific neck pain.
• To compare the efficacy of Sensory-Threshold burst High-Frequency Stimulation (ST-bHFS) and Motor-Threshold Theta-Burst Stimulation (MT-TBS) against an active control (TENS).

Main Methods:

• 45 participants were randomized into three groups: ST-bHFS, MT-TBS, or 80 Hz TENS (active control).
• Pain was assessed using a verbal numerical rating scale (VRNS) for spontaneous and movement-induced pain.
• Maximal strength and electromyography of the upper trapezius were evaluated pre- and post-treatment.

Main Results:

• ST-bHFS significantly reduced spontaneous neck pain (p < 0.001), an effect not observed with MT-TBS or TENS.
• All protocols reduced movement-induced pain, though only MT-TBS and ST-bHFS achieved clinical relevance.
• Pain reduction persisted for one week post-treatment in both pPNS groups (MT-TBS and ST-bHFS), unlike the TENS group.

Conclusions:

• pPNS protocols, particularly ST-bHFS, offer an effective non-pharmacological treatment for non-specific neck pain.
• The observed pain reduction, especially for spontaneous pain, and its persistence highlight pPNS as a promising therapeutic option.
• These findings support the translation of plasticity-inducing pPNS protocols into clinical practice for pain management and future research.