Remote electrical neuromodulation for reducing procedural pain in patients with chronic migraine receiving onabotulinumtoxinA injections: A randomized sham-controlled study

Comprehensive Summary

This study by Nan Cheng and colleagues focuses on reducing or eliminating pain caused by the OnabotulinumtoxinA (BoNT-A) procedure. This procedure is used as a preventative medicine for chronic migraines, but it involves dozens of frequent injections and often leads to postprocedural pain. Cheng proposes using remote electrical neuromodulation (REN) as a therapy to reduce this acute pain. To determine whether REN effectively reduces pain from injections, the study examined its performance in 80 adults. Each of these participants first underwent one round of treatment without REN. For the following treatment sessions, REN or a sham (fake device) was used in a randomized fashion. The participants rated their pain levels before, during, and after each procedure. What was found was that pain was reduced by 15% during the procedure and by 19% after the procedure with the use of REN, whereas the sham procedure did not significantly reduce pain. Furthermore, the sham seemed to have caused an increase in postprocedural headache, whereas the REN lowered this incidence by over half.

Outcomes and Implications

Through this study, REN therapy has proven to significantly reduce pre-, intra-, and post-procedural pain and lessen the number of individuals experiencing post-procedural headache. This could be a breakthrough method to aid in patient comfort and pain management for those suffering from chronic migraines. The device provides a noninvasive, easy-to-use method to mitigate pain and shows promising results in clinical applications. Because the benefits of using REN to combat this uncomfortable experience for patients are now obvious, future research can expand to larger studies and focus on real-world implementation.