TMS for Chronic Pain

Chronic pain can affect far more than the body, including mental health and quality of life. Here’s what you need to know about TMS for pain relief.

TMS for Chronic pain

Article Contents

What is Chronic Pain?

Before discussing TMS for chronic pain, let’s first explore what chronic pain is. Pain is a normal response to injury. It is a sign that something is wrong and needs attention. Most pain happens quickly, and even significant pain can go away after the cause is removed or healed. However, not all pain is acute.  

Chronic pain is defined as pain that lasts longer than three months, even after the original cause of the pain has healed. It is very common: the CDC estimates that about 50 million U.S. adults experience pain every year.1

Symptoms 

Chronic pain is different depending on the cause and the individual. It can be anywhere from mild to severe. It is a daily pain for some people, while for others, it can come and go. This pain can manifest as:

  • Throbbing 
  • Burning 
  • Dull pain 
  • Shooting 
  • Stinging 
  • Soreness 
  • Stiffness 

Chronic pain can interrupt your daily life. More than the physical pain, other symptoms of chronic pain also include:

  • Lack of or increase in appetite 
  • Fatigue or lack of energy 
  • Weakness 
  • Mood changes 
  • Difficulty sleeping 
  • Tense muscles

Causes  

There are times where chronic pain appears without an apparent cause. However, most of the time, it comes from a health condition or after an injury. The most common causes of chronic pain include: 

  • Back issues 
  • Migraines and recurring headaches 
  • Arthritis 
  • Former injuries or surgeries 
  • Nerve damage
  • Inflammation 
  • Infections 
  • Past trauma 

Diagnosis  

Chronic pain is largely self-diagnosed, although always check with a doctor to ensure no other underlying condition. 

Chronic Pain and Mental Health 

Chronic pain syndrome is far more than physical. Learning to handle the mental load of constant pain, as well as figuring out how to navigate life with pain, can take a cognitive load. It is common for chronic pain to take a toll on mental health.  

Those with chronic pain are at an increased risk of developing an alcohol or substance use disorder as a means of coping with the pain. Chronic pain can also have an impact on other areas of emotional health, including: 

  • Depression 
  • Stress  
  • Sleep 
  • Anxiety, especially over re-injury 

Types of Pain

There are multiple types of pain that the body can experience. Each one typically requires a different response: 

Acute 

Acute pain is sharp but does not last longer than six months. It typically comes on suddenly and has a definitive cause, such as: 

  • Broken bones 
  • Dental work
  • Labor and childbirth 
  • Surgery 
  • Cuts or burns 

Once the acute pain is gone, life can continue as usual. It may lead to some soreness during healing, but it does not last for a significant amount of time.

Chronic 

Chronic pain syndrome, on the other hand, continues even after the cause is gone. The pain signals are still active in the nervous system months or years after the original injury.  

Nociceptive pain 

Nociceptive pain describes pain that comes from physical damage to the body. Nociceptive pain can come from 

  • Arthritis 
  • Surgery 
  • Sports injury 

It is typically acute pain and provides warning signals to the rest of the body. For example, people know not to touch a hot pan because our nerves quickly correct that mistake! However, in some cases, it can turn into neuropathic pain.

Neuropathic Pain 

Neuropathic pain is a pain that arises when the nervous system itself is damaged or not working correctly. 

It is different from nociceptive pain in that there is no outside circumstance or stimulus that leads to the pain. It is also called nerve pain and is often chronic in nature. 

Some conditions that can cause neuropathic pain include: 

  • Stroke 
  • Cancer 
  • Diabetes 
  • Multiple Sclerosis 
  • Amputation
  • Cytomegalovirus 

Alternative Therapy for Chronic Pain

Depending on the cause of the chronic pain, several treatment options can help to provide relief: 

Physical Therapy 

Chronic pain can often impair movement and ability to function. Physical therapy can help decrease pain and inflammation and increase mobility to help you fully function. Common treatments include exercise to improve mobility and strength, ultrasounds for deep heating modality, electrical stimulation to decrease pain signals, massage for improving blood flow, and heat and ice to reduce inflammation. 

A physical therapist can help you create specific goals and an actionable plan to accomplish them. 

Acupuncture 

Although it can be controversial,  research shows that acupuncture can be an effective treatment with wide clinical practice. Acupuncture works by inserting hair-thin needs into specific points in the skin around the body. When done correctly by an experienced practitioner, it is virtually painless.2

Acupuncture has long been used in Traditional Chinese Medicine to correct imbalances within the body. Many western researchers believe that it might be able to relieve pain by affecting neurotransmitters, decreasing inflammation and hormone levels in the body.    

Lifestyle Changes 

While professional help can facilitate healing, taking control of your health can also bring significant relief. Some lifestyle changes that can help improve chronic pain include: 

  • Reduce stress levels. 
  • Get out into nature, whether walking or even just sitting outside. 
  • While proper sleep can be challenging with chronic pain, maintaining good sleep hygiene can help reduce irritation and fatigue associated with chronic pain.  
  • Eat a colorful diet to help lower inflammation. 
  • Reduce or eliminate alcohol intake to improve sleep and encourage healthy coping mechanisms. 

Relaxation Therapy 

Chronic pain syndrome can make relaxation challenging. Tense muscles and anxiety are just a couple of symptoms of chronic pain that can interfere with relaxation. However, relaxation exercises can help you manage your chronic pain. It can help lower stress hormones in the body, relax the tension that can make the pain even worse, and help counteract the impact of stress. 

Some pain management techniques in relaxation therapy include Box breathing, guided imagery, hypnosis, meditation, and guided imagery.

What is TMS?

While these therapies can all be effective for many people, others still experience chronic pain. Transcranial magnetic stimulation could help. Also called TMS treatment or rTMS (for repetitive TMS) is a form of therapy that uses neurostimulation to help facilitate healing in the brain. TMS for pain relief could help those who still experience pain even after trying other treatments. 

How can TMS help in chronic pain treatment?

Currently, the only FDA-approved use for transcranial magnetic stimulation is for depression and suicide ideation. However, research suggests that it can be used for chronic pain management as well. rTSM therapy is especially useful for neuropathic pain as it can enable the brain to heal the damage that leads to chronic pain for some people.3 While pain signals travel through the body, pain itself is ultimately the brain that experienced pain. TMS for pain can change the activity of neural networks within the brain to decrease the perception of pain. 

What to Expect in TMS Therapy?

For those whose alternative treatments have failed, TMS for pain can provide some help. 

How Long is the Therapy? 

The average person using TMS for pain has somewhere between 25-30 sessions, depending on their unique needs. Each TMS treatment takes about 30-40 minutes. 

Many start to see improvements in the first couple of weeks, depending on the severity and type of pain. 

How to Prepare for TMS? 

To make sure that rTMS is a positive experience and an effective option, you will need to complete a physical exam, as well as other lab tests. In addition, you will also need a psychiatric evaluation. 

Who Administers TMS? 

TMS for pain is usually performed at a specialist’s office under a qualified physician or TMS technician 

Who Cannot Get TMS Therapy? 

While TMS for pain is a relatively safe and non-invasive therapy, it is not for everyone. Those who should not have treatment include:4

  • Those with metal or implanted medical devices 
  • Those who are pregnant
  • Those with a history of seizures or family history of epilepsy 
  • Brain damage from illness or injury, such as a stroke.
  • Frequent or severe headaches 
  • With certain other medical conditions 

Always speak with your doctor about any other medication or supplements you are taking before starting TMS for pain.

Benefits of TMS Therapy 

TMS for pain can offer many benefits for those who have chronic pain. TMS therapy is especially useful for those who haven’t responded to other forms of treatment. Because it focuses on reforming that altering the structures in the brain, rTMS can help facilitate lasting change. Some other benefits include:5

  • High-success rate
  • Non-invasive
  • No-side effects 

For those who need help with pain management, TMS therapy can provide valuable relief!

  1. https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm
  2. https://pubmed.ncbi.nlm.nih.gov/29198932/
  3. https://pubmed.ncbi.nlm.nih.gov/25240669/
  4. https://www.nami.org/About-Mental-Illness/Treatments/ECT,-TMS-and-Other-Brain-Stimulation-Therapies
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047114/

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