Treatment of Back Pain Using Transcutaneous Magnetic Stimulation (TCMS)

Not Applicable

Completed

Conditions: Lower Back Pain

Interventions: Device: Placebo
Device: Fischell Transcutaneous Magnetic Stimulation Pain Treatment Device

Registration Number: NCT02421757

Lead Sponsor: University of Maryland, Baltimore

Brief Summary: This is a single-site, randomized, Single-blinded, placebo-controlled, trial of Transcutaneous Magnetic Stimulation (TCMS) for the treatment of lower back pain. TCMS will be applied locally to the back in the location of a patient's pain.

Detailed Description: Approximately one third of Americans suffer from acute and chronic pain and pain has been called a silent epidemic. Treatment of pain often involves opioid medications with a significant potential for abuse, addiction and adverse reactions such as respiratory depression and death. Magnetic brain stimulation has been used for the treatment of pain. There are reports of its use in phantom-limb pain and in the treatment of central and peripheral pain syndromes.

The study will evaluate whether an experimental medical device (Fischell TCMS Pain Treatment Device) that emits pulses of a brief, intense magnetic field will relieve pain in the lower back. Transcutaneous Magnetic Stimulation (TCMS) is the name of this method of delivering magnetic pulses through the skin. TCMS has been approved by the FDA for peripheral nerve stimulation, treatment of migraine headaches and for depression but this type of device has not been studied scientifically for the treatment of back pain. No significant adverse reactions or side effects have been reported with the use of magnetic stimulation for headache treatment. Some patients who have migraine headaches have excellent pain relief with the magnetic treatment even if they do not get pain relief with medications. Other patients do not have headache relief with magnetic treatment. The current use of TCMS applied to the head requires special equipment and multiple treatment sessions. TCMS applied peripherally is easier to do, and may require fewer treatment sessions to achieve pain relief. Non-invasive treatment of pain would represent a significant advance in the field especially if its use both successfully treated pain and resulted in the reduction or elimination in the need for opioid medications.

The investigators do not know whether magnetic treatment will relieve back pain so the investigators will test this by applying a powerful electromagnet to the area of the back having pain. In some patients, the magnet will be turned on, but in other patients the magnet will not be turned on. Neither patients nor patient's treating doctor will know whether the magnet was turned on or not, although the study team will know which patients received treatment with magnetic pulses. The effect on pain will be recorded periodically for 2 days. If the patients' reported pain is reduced by having the magnet turned on compared to patients' who do not have the magnet turned on, then the magnet may have reduced the pain. Additional studies in patients will be needed to be sure that the magnet therapy is reducing low back pain.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 20

Inclusion Criteria

Adult, age >18 years of age
Prescription pharmacologic treatment is insufficient for treatment of pain
Pain duration of ≥ 6 months
Pain limits physical activity
Pain occurs daily
Chronic low back pain, with or without leg pain, associated with MRI or other imaging study consistent with lumbo-sacral spine disease with or without nerve compression
Pain intensity ≥ 5 at the time of enrollment a a self-reported pain score of ≥ 4 over the 7 preceding days.

Exclusion Criteria

Life expectancy ≤ 6 months for any reason
Oral opiate dosing or type of opioid that has changed in past 12 months
Received intraspinal (e.g., epidural, intrathecal) medication in the past 6 months
Use of intravenous pain medication in the past 6 months
Active use of a transcutaneous electrical nerve stimulator (TENS) [within 30 days]
History of seizures
History of implanted medical device, cardiac pacemaker or implantable cardiac defibrillator, or other implant (Cochlear etc)
History of cardiac dysrhythmias
Member of vulnerable population
Current or potential legal action of disability claim related to back pain
Body Mass Index (BMI) >35
Another pain condition that might confound results, including back pain above the waistline
Women of child-bearing potential
Inability to undergo study assessments or complete questionnaires independently
Metal objects in the body (i.e. Aneurysm clip, bullet fragment)
Active psychological co-morbidites (i.e. uncontrolled schizophrenia)

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Sham Device	Placebo	Sham Device
Transcutaneous Magnetic Stimulation	Fischell Transcutaneous Magnetic Stimulation Pain Treatment Device	Transcutaneous Magnetic Stimulation

Primary Outcome Measures

Name	Time	Method
Immediate Pain Measured by Numeric Pain Rating Scale (NPRS)	60 minutes	Immediate relief measured by Numeric Pain Rating Scale (NPRS) Scale from 0-10 0=No pain 10= Worse possible pain

Secondary Outcome Measures

Name	Time	Method
Durable Pain Measured by Numeric Pain Rating Scale (NPRS)	30 days	Durable pain relief measured by Numeric Pain Rating Scale (NPRS) 0= No pain 10= Worse imaginable pain