Anodal transcranial direct current stimulation for chronic pain in the elderly: a pilot study

Background and aims: Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique that can affect human pain perception. The present open-label, single-arm study investigated whether primary motor cortex anodal tDCS treatment reduces chronic foot pain intensity and improves depression and pain-related anxiety symptoms in patients with chronic plantar fasciitis. Methods: Ten patients with symptomatic treatment-resistant plantar fasciitis were enrolled in the study. The treatment consisted of anodal tDCS over the motor area of the leg contralateral to the symptomatic foot for 20 min, at 2 mA for 5 consecutive days. Pre-tDCS (T0), post-tDCS (T1), 1 week (T2), and 4 weeks (T3) post-treatment assessments were conducted consisting of the Visual Analog Scale for pain intensity, the Foot Function Index (FFI), the Pain Anxiety Symptom Scale (PASS-20), and the Hamilton Rating Scale for Depression (HDRS-17 items). Results: Anodal tDCS treatment induced a significant improvement in pain intensity; FFI and PASS scores that were maintained up to 4 weeks post-treatment. In addition, patients reported taking fewer pain medication tablets following the treatments. Discussion and conclusions: Our results indicate that anodal tDCS may be a viable treatment to control pain and psychological comorbidity in elderly patients with treatment-resistant foot pain.