By Dr. David Woo - August 22, 2022

Deep TMS is FDA-approved to treat mood and behavioral disorders, including depression and OCD (obsessive-compulsive disorder). But studies show that Deep TMS may also be a safe and effective treatment for chronic pain.

What Is Chronic Pain?

Chronic pain is defined as pain that lasts longer than three months, although some people will experience chronic pain for years. While chronic pain can occur anywhere in the body, it most commonly occurs in the hips, knees, feet, and back.(1,2)

Chronic pain can be constant and unrelenting, or it can come and go, and may show up as many different types of pain, including:(1)

• Dull aches
• Throbbing
• Stiffness or soreness
• Burning or stinging
• Shooting

Many different conditions can cause chronic pain, such as:(1,3)

• Pain that lingers after an injury or an accident, long after the injury should have fully recovered
• Fibromyalgia (a condition characterized by widespread pain)
• Pain caused by illness or disease, like cancer, arthritis, or an infection
• Neuropathy (nerve damage), which can be caused by chronic conditions like diabetes

In addition to the physical conditions listed above that are known to cause chronic pain, mental health conditions, like anxiety and depression, can cause or even worsen chronic pain symptoms.

The Connection between Chronic Pain and Mental Health

Chronic pain can be extremely difficult to live with and can take a toll on one’s mental health. Additionally, mental health conditions, such as depression, anxiety, and insomnia can contribute to chronic pain.(1)

For example, in the case of depression, depression is linked to the onset of chronic pain symptoms and chronic pain can worsen depression symptoms, increasing the risk of depression relapse (the return of depression symptoms). 

Current Treatment Options for Chronic Pain

Medication and cognitive-behavioral therapy (a type of talk therapy) are the most common methods used to treat chronic pain. While chronic pain generally responds to medication, medication can come with unpleasant side effects, including liver damage and addiction. Medications used to treat chronic pain include:(1,4)

• Pain killers
• Muscle relaxers
• Anti-inflammatory drugs
• Antidepressants for depressive symptoms associated with pain
• Sedatives to improve sleep quality

Other therapies used to treat chronic pain include:(1,2) 

• Physical therapy
• Acupuncture
• Massage
• Lifestyle changes, such as adjustments to sleep, diet, and exercise habits

Research tells us that Deep TMS (deep transcranial magnetic stimulation) may be a safe and effective, medication-free, treatment option for chronic pain. 

Deep Transcranial Magnetic Stimulation (Deep TMS) for Chronic Pain

Deep transcranial magnetic stimulation (dTMS) is a medication-free treatment that uses magnetic pulses (similar to those emitted by an MRI machine) to moderate activity in certain regions of the brain. In the case of chronic pain, dTMS is used to target brain regions associated with pain perception and pain management in order to relieve symptoms.

Previous studies observing the effects of TMS on chronic pain have mainly focused on traditional repetitive TMS (rTMS). Traditional TMS reaches more superficial (closer to the surface) areas of the brain, while Deep TMS is able to reach deeper areas of the brain. 

TMS has been shown to:

• Help relieve symptoms of chronic pain conditions, including neuropathic pain, fibromyalgia, and complex regional pain syndrome.(5)
• Increase the efficacy of traditional treatments (prescription pain relievers) for chronic pain.(6)

While evidence shows that traditional TMS is safe and effective in relieving pain, studies also show that Deep TMS is safe and effective at relieving pain. One study specifically observed the effects of Deep TMS on neuropathy pain in the lower leg in diabetic patients. Neuropathy pain can be successfully treated with invasive neurostimulation techniques. Scientists aimed to understand the use of noninvasive Deep TMS to relieve pain associated with diabetic neuropathy. Twenty-five participants received either active or sham (placebo) for five consecutive days. Patients who received active Deep TMS therapy, reported pain relief immediately following Deep TMS. (7) 

Learn More about Deep TMS for Chronic Pain

If you or a loved one is living with chronic pain, know that you have treatment options. To learn more about Deep TMS therapy for chronic pain management, contact us online or call us at 212.731.2033 to schedule an appointment.

Resources:

1. Chronic Pain. Cleveland Clinic. Publication Date Unknown. Reviewed September 1, 2021. Link. Accessed July 27, 2022.

2. Yong RJ, Mullins PM, and Bhattacharyya N. Prevalence of chronic pain among adults in the United States. Pain. 2022;163(2):e328-e332. Link. Accessed July 27, 2022.

3. Chronic Pain. Familydoctor.org. Publication Date Unknown. Updated May 2022. Link. Accessed Augut 1, 2022. 

4. Chronic Pain: Medication Decisions. MayoClinic. Published Jan 9, 2021. Link. Accessed July 27, 2022.

5. Galhardoni R, Correia GS, Araujo H, et al. Repetitive transcranial magnetic stimulation in chronic pain: a review of the literature. Arch Phys Med Rehabil. 2015;96(4 Suppl):S156-S172. Link. Accessed July 27, 2022.

6. Goudra B, Shah D, Balu G, et al. Repetitive Transcranial Magnetic Stimulation in Chronic Pain: A Meta-analysis. Anesth Essays Res. 2017;11(3):751-757. Link. Accessed July 27, 2022.

7. Shimizu T, Hosomi K, Maruo T, et al. Efficacy of deep rTMS for neuropathic pain in the lower limb: a randomized, double-blind crossover trial of an H-coil and figure-8 coil. J Neurosurg. 2017;127(5):1172-1180. Link. Accessed July 27, 2022.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.