Effects of transcranial direct current stimulation and neural mobilization on pain and disability in people with chronic radicular pain: a protocol for a sham-controlled randomized trial
摘要
Radicular pain is a very common condition that occurs when spine discopathy leads to nerve root damage; it radiates to the leg with somatotopic distribution. It could cause high levels of pain and disability. When it becomes chronic, central sensitization may be present, which can lead to neuropathic pain. Neural mobilization is a manual approach recommended for the treatment of this condition. Transcranial direct current stimulation (tDCS) has emerged as an alternative treatment for neuropathic chronic pain in an attempt to modulate brain function. The aim of this study is to verify if the effects of tDCS add benefits in decreasing pain intensity, neuropathic symptoms, and disability in individuals with chronic radicular pain when associated with neural mobilization.
MethodsIt is a protocol for a randomized controlled trial to be conducted with individuals with chronic radicular pain divided in two groups: Experimental group (active tDCS + neural mobilization) and control group (sham tDCS + neural mobilization). The primary outcome will be pain intensity, measured through the numerical pain scale; secondary outcomes are disability, assessed by Roland Morris, and neuropathic symptoms, assessed by Douleur Neuropathique Questionnaire and Pain Detect Questionnaire, range of motion on the Single Leg Raise Test, pressure pain threshold, and two-point discrimination. Perceived Global Effect Scale will also be used. The assessment will be performed before and after the five consecutive days’ intervention protocol and at 7 and 14 days of follow-up for pain intensity. Data will be analyzed by SPSS software; Kolmogorov-Smirnov and Levene tests will be applied to verify the normality and homogeneity of the sample. Then, a repeated measure ANOVA will be performed for comparison over time. A statistical significance level of 5% and a 95% confidence interval will be assumed.
DiscussionThis study would elucidate the possible tDCS effects on radicular pain, which could be pointed out as a new therapeutic tool for this difficult management condition.
Trial registration numberRBR-2d3jj9t/U1111-1289-8248 REBEC. Registered on 04/06/2023