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Transcutaneous vagus nerve stimulation reduces pain, improves function, and shows lasting benefits in knee osteoarthritis, with no serious adverse events.
A 12-week randomized controlled trial suggests that transcutaneous vagus nerve stimulation (tVNS) may provide significant pain relief and improve function in patients with knee osteoarthritis (OA).
The aim of the study was to examine tVNS as a pain modulator in knee osteoarthritis. In total, 68 patients with chronic knee OA were divided into two groups: one receiving active tVNS and the other undergoing sham stimulation (34 participants in each group).
A novel approach was employed, utilizing a transcutaneous electrical nerve stimulation (TENS) device to activate the auricular branch of the vagus nerve, administered three times per week.
To assess the impact of tVNS, researchers utilized multiple outcomes, comprising knee injury and osteoarthritis outcome score (KOOS) for function, visual analog scale (VAS) for pain intensity, pressure pain threshold (PPT) for sensitivity, and neuropathic pain assessments using the PainDETECT (PD-Q) and Douleur Neuropathique 4 (DN4) questionnaires. These evaluations were carried out at baseline, immediately after the 12-week intervention, and again at the 4-week follow-up to determine the persistence of effects.
Those in the active tVNS group exhibited a marked reduction in pain levels, with VAS scores improving markedly between the 1st and 2nd follow-up assessments. Additionally, PPT increased notably in the right knee, left knee, and right elbow, and these improvements were sustained for 4 weeks after the intervention. In contrast, the sham group displayed a temporary improvement in right knee PPT, but the effect did not persist over time. Neuropathic pain assessments further supported the effectiveness of tVNS, with statistically significant improvements in PD-Q and DN4 scores observed only in the active group.
Meanwhile, the sham group illustrated no improvement in DN4 scores. Regarding functional recovery, only those receiving active tVNS experienced substantial gains in KOOS scores (31.44 ± 18.49), reflecting enhanced knee function and mobility. Notably, no serious adverse events were recorded. Thus, tVNS offers therapeutic benefits for OA, highlighting its potential role as a complementary approach alongside pharmacological and non-pharmacological treatments.
BMC Musculoskeletal Disorders
Transcutaneous vagus nerve stimulation as a pain modulator in knee osteoarthritis: a randomized controlled clinical trial
Gehad Gamal Elsehrawy et al.
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