Combining brain stimulation with steroid injections for chronic spinal pain relief
Repetitive Transcranial Magnetic Stimulation Combined with Steroid Joint Injection for the Treatment of Chronic Spinal Pain: Protocol for a Pilot Randomized Controlled Trial
NA · London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's · NCT05840354
This study is testing whether combining brain stimulation with steroid injections can provide better and longer-lasting pain relief for people with chronic spinal pain.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 40 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's (other) |
| Locations | 2 sites (London, Ontario and 1 other locations) |
| Trial ID | NCT05840354 on ClinicalTrials.gov |
What this trial studies
This pilot randomized controlled trial investigates the effectiveness of combining repetitive transcranial magnetic stimulation (rTMS) with steroid joint injections (SJI) in individuals suffering from chronic spinal pain (CSP). The study aims to assess the feasibility, tolerability, safety, and patient response to this combined intervention. Participants will be randomly assigned to receive either active rTMS with SJI or sham rTMS with SJI, with the goal of determining if the combination leads to greater and longer-lasting pain relief compared to SJI alone. The study is conducted at St. Joseph's Health Centre Pain Clinic in London, Ontario, Canada.
Who should consider this trial
Good fit: Ideal candidates are individuals currently receiving recurrent steroid joint injections for chronic spinal pain with a pain intensity of at least 4 out of 10.
Not a fit: Patients with serious spinal pathologies, recent spinal surgery, or uncontrolled mental health conditions may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could provide longer-lasting pain relief for patients with chronic spinal pain.
How similar studies have performed: While previous studies have shown rTMS may provide long-term pain relief in chronic back pain, this specific combination with SJI has not been extensively tested, making it a novel approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Currently receiving recurrent steroid joint injections for control of chronic spinal pain at the St. Joseph's Health Centre Pain Clinic in London, Ontario, Canada, * Have pain in the spinal region of an intensity ≥4 out of 10 in the week before your most recent steroid joint injection, * Have received at least 2 steroid joint injections within the last 12 months at regular intervals * Have had a consistent medication regimen for the past 3 months. Exclusion Criteria: * Unable to read, understand, and speak English and are not able to give consent * Known or suspected serious spinal pathology (tumour, fracture, dislocation, scoliosis) * Spinal surgery in the past 12 months * History of uncontrolled mental health condition(s) * Meet any specific rTMS-related exclusion criteria listed on the safety screening questionnaire (S1; Rossi et al., 2008).
Where this trial is running
London, Ontario and 1 other locations
- St. Joseph's Health Care London — London, Ontario, Canada (RECRUITING)
- Parkwood Institute (Main Building) — London, Ontario, Canada (RECRUITING)
Study contacts
- Principal investigator: Siobhan Schabrun — London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
- Study coordinator: Alexandria Roa Agudelo, MLA
- Email: alexandria.roaagudelo@sjhc.london.on.ca
- Phone: 519-646-6100
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Chronic Spinal Pain, repetitive transcranial magnetic stimulation, steroid joint injection, inflammatory markers, inflammation, chronic pain