Published online May 28, 2017. doi: 10.3748/wjg.v23.i20.3758
Peer-review started: November 21, 2016
First decision: February 10, 2017
Revised: March 10, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: May 28, 2017
Chronic abdominal and pelvic pain is a common condition that has significant impact on quality of life, and causes billions of dollars in direct and indirect costs. Emerging data suggest that transcranial direct current stimulation (tDCS), alone or in combination with transcutaneous electrical nerve stimulation (TENS), could be a promising therapeutic avenue to reduce chronic pain. The encouraging results coming from these studies prompted us to try combining TENS and tDCS in 4 of our patients who suffered from chronic abdominal/pelvic pain and to compare the effect with 5 other patients who received TENS alone. Pain intensity was assessed with a visual analog scale before, during and after the stimulation. We observed that there was a slight decrease in pain which was similar in both patient groups (TENS alone and TENS combined with tDCS). These observations suggest that combining TENS and tDCS in patients suffering from chronic pelvic and/or abdominal pain produces no additional benefit, compared to TENS alone. Future studies, looking at the effect of several/consecutive TENS and tDCS sessions should be conducted.
Core tip: Past studies have showed that combining transcutaneous electrical nerve stimulation (TENS) and transcranial direct current stimulation (tDCS) can be an effective strategy to relieve chronic pain. In this letter, we describe the observations made on nine patients suffering from chronic pelvic and/or abdominal pain. Combining TENS and tDCS produced negligible effect on pain. The reduction in pain noted after the application of TENS and tDCS was comparable to the reduction noted after the application of TENS only. These clinical observations question the added value of tDCS in patients suffering from chronic pelvic and abdominal pain.