Over 30% of neuropathic pain conditions in Veterans are due to peripheral nerve injury from physical or surgical related trauma. Peripheral nerve injury often results in the formation of neuroma/nerve entrapment, a persistent neuropathic pain state accompanied by sensory hypersensitivity and uncontrollable spontaneous pain sensation at the injury site. Current available medications for neuropathic pain often consist of untoward side effects and/or abusive risks. Invasive measures such as surgical resection or local injections of steroid and local anesthetics at the injury/neuroma site are often ineffective in alleviating the symptoms and the invasive nature of the procedure is usually painful for the patients. Therefore, there is a need in the field of pain management in developing means of non-invasive and non-contact therapy in treating post-traumatic peripheral neuropathic pain (PTP-NP) states. The pain service at the VA San Diego Healthcare System (VASDHS) has recently adopted the use of transcutaneous magnetic stimulation (tMS) in treating PTP-NP and noticed encouraging pain relief benefit in patients with PTP-NP. The PI also completed a mechanistic nerve conduction study and showed that this treatment method can potentially restore lost neuronal functions associated with PTP-NP. Our initial pilot data from a randomized controlled study support the feasibility of conducting a larger scale randomized controlled clinical trial to adequately assess the effect of tMS in treating PTP-NP and improving patients' function. To validate tMS as a non-contact and non-invasive pain treatment option for reducing pain in Veterans with PTP-NP and improving their overall functions, the proposed study will assess: 1) the effect of transcutaneous magnetic stimulation (tMS) in alleviating post-traumatic peripheral neuropathic pain (PTP-NP); 2) the effect of tMS in improving quality of life and functions in Veterans with PTP-NP.
Post-traumatic peripheral neuropathy pain (PTP-NP) is a common debilitating condition adversely affecting Veterans with service or surgically related injuries. Unfortunately, current options of pain medications or invasive interventional procedures are often ineffective in alleviating their pain, and sometimes the invasive nature of these interventions can further exacerbate their pre-existing pain condition. Therefore, there is a need in the field of pain management in developing means of non-invasive and non-pharmacological therapy(ies) in treating PTP-NP. The pain service at the VA San Diego Healthcare System has recently adopted the use of transcutaneous magnetic stimulation (tMS) in treating PTP-NP and noticed encouraging pain relief benefit in patients with PTP-NP. The proposed study will provide the further validation for this non-invasive therapy in reducing Veterans' pain, and improving their functions and quality of life.
