Improving Chronic Spinal Pain with Exercise and Brain Stimulation A Randomized Trial for Patients with Persistent Spinal Pain Syndrome Type 2

What this Trial Is About

Chronic spinal pain, particularly Persistent Spinal Pain Syndrome Type 2 PSPS-T2, is a complex condition often without clear structural causes and includes symptoms like severe disability and reduced quality of life. This trial evaluates the combination of transcranial direct current stimulation tDCS and motor control exercises versus exercises alone for patients with PSPS-T2 who have not improved with usual treatments. The goal is to improve function, reduce pain, and enhance psychological health through a patient-focused approach. Participants will be randomly assigned to two groups one receiving 20 minutes of tDCS at 1.5 mA targeting the left dorsolateral prefrontal cortex alongside motor control exercises, and a control group receiving only the exercises with a brief sham tDCS to mimic sensations. The exercise program includes core stabilization and strength training with specific breathing techniques and ultrasound feedback for muscle activation. The tDCS uses saline-soaked sponge electrodes placed according to EEG standards, with ramp-up and ramp-down periods to optimize safety and comfort. Throughout the study, participants will be assessed before treatment and at 1, 3, and 6 months after starting. Measurements include the Oswestry Disability Index for function, pain scales, psychological questionnaires, and assessments of neuropathic pain and depression. The trial tracks outcomes related to pain, disability, and mental health, aiming to provide new insights into managing PSPS-T2 with combined neuromodulation and exercise. The total duration includes baseline and multiple follow-up visits to evaluate lasting effects.

Managing Chronic Spinal Pain With Exercise and Neuromodulation