Relieving Chronic Musculoskeletal Pain in Older Adults Using Transcranial Direct Current Stimulation: Effects on Pain Intensity, Quality, and Pain-Related Outcomes

Abstract

IntroductionChronic pain is a significant health problem and is particularly prevalent amongst the elderly. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has been proposed to reduce chronic pain. The aim of this study was to evaluate and compare the efficacy of active and sham tDCS in reducing pain in older individuals living with chronic musculoskeletal pain.Materials and MethodsTwenty-four older individuals (mean age: 68 ± 7 years) suffering from chronic musculoskeletal pain were randomized to receive either anodal tDCS over the contralateral motor cortex (2 mA, 20 min; n = 12) or sham tDCS (20 min; n = 12) for five consecutive days. Pain logbooks were used to measure pain intensity. Questionnaires (McGill Pain Questionnaire, Brief Pain Inventory, Beck Depression Inventory [BDI], Beck Anxiety Inventory, Pain Catastrophizing Scale [PCS], and Margolis Pain Drawing and Scoring System [MPDSS]) were also used to assess pain in its globality.ResultsAnalysis of pain logbooks revealed that active tDCS led to a reduction in daily average pain intensity (all p ≤ 0.04), while sham tDCS did not produce any change (p = 0.15). Between-group comparisons for change in pain intensity reduction between active and sham tDCS showed a trend during treatment (p = 0.08) which was significant at the follow-up period (p = 0.02). Active tDCS also improved scores of all questionnaires (all p ≤ 0.02), while sham tDCS only reduced MPDSS scores (p = 0.04). Between-group comparisons for the pain-related outcomes showed significant differences for BDI et PCS after the last tDCS session.ConclusionsThese results suggest that anodal tDCS applied over the primary motor cortex is an effective modality to decrease pain in older individuals. tDCS can also improve other key outcomes, such as physical and emotional functioning, and catastrophic thinking.

Targeting Neuroplasticity for the Management of Pain and Agitation in Alzheimer’s Disease via Bergamot Nanotherapy

“…Agitation includes inappropriate verbal, vocal, or motor activity and might be aggressive, inappropriate in frequency, or related to the social context [28]. With age, AD patients are more likely to experience chronic pain due to musculoskeletal pain, which is the leading cause of disability among the elderly [29,30], rheumatic conditions [31][32][33], neuropathies with up to 60% prevalence, such as diabetes [34] and shingles due to herpes Zoster infection [35] or spinal surgery [36], injury [37], and stroke [38]. Unfortunately, people suffering from AD who receive pharmacological treatment for pain are fewer than their peers with intact cognitive abilities in the general population of the elderly [39].…”

Effects of Palmitoylethanolamide (PEA) on Nociceptive, Musculoskeletal and Neuropathic Pain: Systematic Review and Meta-Analysis of Clinical Evidence

“…Moreover, it is now widely known that patients with common rheumatic conditions present neuropathic features [10][11][12], in spite of the nociceptive and inflammatory nature of this type of pain [13]. All these painful conditions increase with the aging of the population, making chronic musculoskeletal pain the leading cause of disability among the elderly [14,15]. In this fragile population, the issue of pain is even more difficult to deal with due to the lack of information on appropriate use of analgesics, in terms of tolerance and addiction (for opioids as well as gabapentinoids) [16][17][18][19], dosage and type, physiological differences and variability in pain processing [20], response to drugs [21] and polypharmacy [22].…”

Analgesic Characteristics of NanoBEO Released by an Airless Dispenser for the Control of Agitation in Severe Dementia

“…Patients often come to clinical observation because of chronic pain [ 1 ], among which low back pain [ 2 ] is one of the most disabling conditions, with a global lifetime prevalence of about 39% [ 3 ]. Chronic pain acquires more importance in the elderly [ 4 , 5 ] for several reasons. This fragile population most often experiences chronic pain due to age-related comorbidities, such as diabetes [ 6 ] and shingles due to herpes zoster infection [ 7 ], but also injury [ 8 ], stroke [ 9 ], and rheumatic conditions, usually including neuropathic features [ 10 , 11 , 12 ].…”