Effects of transcranial direct current stimulation associated or combined with exercise on musculoskeletal pain: systematic review

Abstract

BACKGROUND AND OBJECTIVES: Aerobic/resistance exercises and transcranial direct current stimulation (tDCS) can produce analgesic effects in patients with musculoskeletal pain, however, the summed effect of these two therapeutic resources remains unclear. The present study aimed to verify the effects of tDCS associated or combined with aerobic/resistance exercise on musculoskeletal pain. CONTENTS:The search was carried out in the databases: Pubmed, LILACS, Scielo. The intervention considered was tDCS associated or combined with exercises and the comparison was exercise without tDCS or with sham tDCS. Randomized controlled trials enrolling patients with musculoskeletal pain were included. There were no restrictions on the language and year of publication and the methodological quality was verified with PEDro Scale. Three trials were included with a total of 110 participants. The methodological quality was high, with an average of 9 points on the PEDro Scale. The studies used tDCS in the primary motor cortex with an intensity of 1 or 2 mA, for 20 minutes. The participants included were aged between 18 and 75 years and had the following diseases: fibromyalgia, osteoarthritis or chronic low back pain. CONCLUSION: Overall, tDCS did not overcome the sham tDCS to enhance the effects of exercise in reducing musculoskeletal pain.

Transcranial Direct Current Stimulation combined with Physiotherapy in the control of Chronic Pelvic Pain: a case report

“…This stimulation modulates neural excitability, being able to both inhibit and excite cortical and subcortical regions, resulting in the stimulation and release of endogenous opioids that facilitate pain modulation. 6 tDCS is an accessible, safe and easy-to-administer therapy that can be advantageous for chronic pain, with minimal side effects, which promotes patient adherence. 4 Anodal current stimulation enhances cortical excitability, facilitating neuronal membrane depolarization, while cathodal current stimulation has an inhibitory effect, inducing neuronal membrane hyperpolarization.…”