Effectiveness of non-invasive vagal nerve stimulation on inflammatory low back pain in spondyloarthritis

Abstract

Background
Vagus nerve stimulation holds promise for treating inflammatory diseases. Several studies explored its effectiveness in managing inflammatory low back pain in spondyloarthritis. This study aims to evaluate the effectiveness of Non-Invasive Vagal Nerve Stimulation on inflammatory low back pain in spondyloarthritis and to assess its impact on functional outcomes among worker and non-worker patients.


Methodology
A randomized controlled parallel‑group trial was done on Fifty Spondyloarthritis patients underwent full medical & occupational history & clinical examination including the Visual Analogue Scale (VAS), Modified Schober Test (MST), Beck Depression Scale (BDS) and Pittsburgh Sleep Quality Index (PSQI), at baseline and 3weeks later. Patients were allocated randomly by simple randomization by computer program into: Intervention group (25) received Vagus nerve stimulation beside the conventional treatment & control group (25) received conventional treatment only. Assessors were blinded to group allocation and intervention, also patients were blinded, effect sizes were calculated to assess the magnitude of differences between groups.


Results

After 3 weeks, Vagus nerve stimulation group showed clinical improvement indicated by statistically significant decrease in VAS (
p
 = 0.031), BDS (
p
 = 0.049) and PSQI (
p
 = 0.031) and increase of MST (
p
 = 0.030) compared with the baseline. In patients received conventional treatment only, no statistically significant improvement between baseline and after 3 weeks of treatment regarding these parameters. [VAS (
P
 = 0.559), MST (
p
 = 0.968), BDS (
p
 = 0.638), and PSQI (
p
 = 0.775)]. In VNS group, workers showed statistically significant decrease in VAS (
p
 = 0.046), BDS (
p
 = 0.030) after 3 weeks compared with the baseline. Non workers didn’t show statistically significant improvement regarding clinical parameters.



Conclusion
Adding Vagus nerve stimulation to conventional treatment was superior to conventional treatment alone regarding pain, sleep, depression and low back movement in Spondyloarthrtis.