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Transcranial Direct Current Stimulation Is Effective for Pain Relief of Individuals With Nonspecific Chronic Low Back
Ricardo Vinicius Silva de Souza1, Mikhail Santos Cerqueira2, Ingrid Martins de França1
1Neuromuscular Performance Laboratory, Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal.
Objective:
To assess the efficacy of transcranial direct current stimulation (tDCS) for pain relief and disability reduction in individuals with nonspecific chronic low back pain (NSCLBP).
Design:
Randomized, double-blind, controlled trial with participants allocated to active tDCS (n=20) or sham tDCS (n=17) groups.
Setting:
University laboratory.
Participants:
A total of 37 individuals aged 18-60 years with NSCLBP.
Intervention:
Participants received ten 20-minute sessions of tDCS (2 mA), administered twice weekly for 5 weeks, targeting the left dorsolateral prefrontal cortex.
Outcome Measures:
Pain intensity (visual analog scale), pressure pain threshold ([PPT], algometry), and disability (Roland-Morris Disability Questionnaire [RMDQ], Oswestry Disability Index [ODI], and sit-to-stand test) were assessed 1 week before the first intervention session and 1 week after the completion of the 10th session. Data were analyzed using 2-way repeated-measures ANOVA (time × group), followed by Tukey's post hoc test (when appropriate). Significance was set at P<.05.
Results:
The active tDCS group showed a significant reduction in pain compared with sham (sham: 4.70±2.59-3.66±2.55; active: 5.40±1.64-2.02±1.72; P=.026). No significant differences were found between groups for PPT (L5R, P=.427; L5L, P=.843; L3R, P=.649; and L3L, P=.788), ODI (P=.113), RMDQ (P=.285), or sit-to-stand performance (P=.726). Both showed similar trends for secondary outcomes (minor improvements), but without significant between-group differences.
Conclusion:
tDCS applied to the dorsolateral prefrontal cortex produced a small but significant pain reduction in individuals with NSCLBP; however, it did not significantly affect pain threshold or disability levels. These findings suggest that although tDCS helps modulate perceived pain, its isolated use may not improve functional disability. Further studies with larger sample sizes, varied stimulation parameters, and combined interventions are needed to clarify the potential role of tDCS in managing NSCLBP.
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