经颅直流电刺激治疗慢性腰痛的研究进展
Research Progress of Transcranial Direct Current Stimulation in the Treatment of Chronic Low Back Pain
DOI: 10.12677/acm.2026.162500, PDF,    科研立项经费支持
作者: 罗 敏*:重庆医科大学附属大学城医院康复科,重庆;达州市民康医院医教科,四川 达州;肖 登#:重庆医科大学附属大学城医院康复科,重庆
关键词: 经颅直流电刺激非侵入性脑刺激慢性腰痛Transcranial Direct Current Stimulation Non-Invasive Brain Stimulation Chronic Low Back Pain
摘要: 慢性腰痛是一种普遍存在且严重影响患者生活质量的疾病。其常用的治疗方式从物理因子治疗、运动疗法、药物治疗等,逐渐转变为脑神经刺激治疗。经颅直流电刺激(Transcranial direct current stimulation, tDCS)是一种非侵入性脑神经调节技术,近年来被逐渐应用于临床。本文就tDCS治疗慢性腰痛的机制、临床疗效及安全性作一综述,旨在为慢性腰痛的治疗提供参考。
Abstract: Chronic low back pain is a widespread disease that seriously affects the quality of life of patients. The commonly used treatment methods have gradually shifted from physical factor therapy, exercise therapy, drug therapy, etc. to brain nerve stimulation therapy. Transcranial direct current stimulation (tDCS) is a non-invasive brain nerve regulation technique and has been gradually applied in clinical practice in recent years. This article reviews the mechanism, clinical efficacy and safety of tDCS in the treatment of chronic low back pain, aiming to provide a reference for the treatment of chronic low back pain.
文章引用:罗敏, 肖登. 经颅直流电刺激治疗慢性腰痛的研究进展[J]. 临床医学进展, 2026, 16(2): 1167-1173. https://doi.org/10.12677/acm.2026.162500

参考文献

[1] Katz, J.N. (2006) Lumbar Disc Disorders and Low-Back Pain: Socioeconomic Factors and Consequences. Journal of Bone and Joint Surgery, 88, 21-24. [Google Scholar] [CrossRef] [PubMed]
[2] Knezevic, N.N., Candido, K.D., Vlaeyen, J.W.S., Van Zundert, J. and Cohen, S.P. (2021) Low Back Pain. The Lancet, 398, 78-92. [Google Scholar] [CrossRef] [PubMed]
[3] Olechowski, C., Gener, M., Aiyer, R. and Mischel, N. (2023) Transcranial Magnetic Stimulation for the Treatment of Chronic Low Back Pain: A Narrative Review. Frontiers in Pain Research, 4, Article ID: 1092158. [Google Scholar] [CrossRef] [PubMed]
[4] Medrano-Escalada, Y., Plaza-Manzano, G., Fernández-de-las-Peñas, C. and Valera-Calero, J.A. (2022) Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain. Tomography, 8, 2153-2163. [Google Scholar] [CrossRef] [PubMed]
[5] Shafiee, S., Kiabi, F.H., Shafizad, M. and Zeydi, A.E. (2016) Repetitive Transcranial Magnetic Stimulation: A Potential Therapeutic Modality for Chronic Low Back Pain. The Korean Journal of Pain, 30, 71-72. [Google Scholar] [CrossRef] [PubMed]
[6] Li, T., Wu, Y., Li, Y., Hodges, S.A., Reddy, S., Chen, L., et al. (2025) Transcutaneous Auricular Nerve Stimulation Modulates the Functional Connectivity of the Descending Pain Modulation System and Reward Network in Patients with Chronic Low Back Pain. Neurotherapeutics, 22, e00611. [Google Scholar] [CrossRef] [PubMed]
[7] Liu, K., Zhang, Q., Chen, L., Zhang, H., Xu, X., Yuan, Z., et al. (2023) Efficacy and Safety of Extracorporeal Shockwave Therapy in Chronic Low Back Pain: A Systematic Review and Meta-Analysis of 632 Patients. Journal of Orthopaedic Surgery and Research, 18, Article No. 455. [Google Scholar] [CrossRef] [PubMed]
[8] Chou, R., Deyo, R., Friedly, J., Skelly, A., Weimer, M., Fu, R., et al. (2017) Systemic Pharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine, 166, 480-492. [Google Scholar] [CrossRef] [PubMed]
[9] Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., et al. (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine, 166, 493-505. [Google Scholar] [CrossRef] [PubMed]
[10] Migliorini, F., Maffulli, N., Eschweiler, J., Betsch, M., Catalano, G., Driessen, A., et al. (2020) The Pharmacological Management of Chronic Lower Back Pain. Expert Opinion on Pharmacotherapy, 22, 109-119. [Google Scholar] [CrossRef] [PubMed]
[11] Konno, S. and Sekiguchi, M. (2018) Association between Brain and Low Back Pain. Journal of Orthopaedic Science, 23, 3-7. [Google Scholar] [CrossRef] [PubMed]
[12] Chiang, M., Hsueh, H., Yeh, T., Cheng, Y., Kao, Y., Chang, K., et al. (2022) Maladaptive Motor Cortical Excitability and Connectivity in Polyneuropathy with Neuropathic Pain. European Journal of Neurology, 29, 1465-1476. [Google Scholar] [CrossRef] [PubMed]
[13] Moseley, G.L. and Flor, H. (2012) Targeting Cortical Representations in the Treatment of Chronic Pain: A Review. Neurorehabilitation and Neural Repair, 26, 646-652. [Google Scholar] [CrossRef] [PubMed]
[14] Parker, R.S., Lewis, G.N., Rice, D.A. and McNair, P.J. (2016) Is Motor Cortical Excitability Altered in People with Chronic Pain? A Systematic Review and Meta-Analysis. Brain Stimulation, 9, 488-500. [Google Scholar] [CrossRef] [PubMed]
[15] O'Connell, N.E., Marston, L., Spencer, S., DeSouza, L.H. and Wand, B.M. (2018) Non-Invasive Brain Stimulation Techniques for Chronic Pain. Cochrane Database of Systematic Reviews, 2018, CD008208. [Google Scholar] [CrossRef] [PubMed]
[16] Luedtke, K., Rushton, A., Wright, C., Geiss, B., Juergens, T.P. and May, A. (2012) Transcranial Direct Current Stimulation for the Reduction of Clinical and Experimentally Induced Pain: A Systematic Review and Meta-Analysis. The Clinical Journal of Pain, 28, 452-461. [Google Scholar] [CrossRef] [PubMed]
[17] David, M.C.M.M., Moraes, A.A.d., Costa, M.L.d. and Franco, C.I.F. (2018) Transcranial Direct Current Stimulation in the Modulation of Neuropathic Pain: A Systematic Review. Neurological Research, 40, 557-565. [Google Scholar] [CrossRef] [PubMed]
[18] Wattananon, P., Thu, K.W., Maharjan, S., Sornkaew, K. and Wang, H. (2023) Cortical Excitability and Multifidus Activation Responses to Transcranial Direct Current Stimulation in Patients with Chronic Low Back Pain during Remission. Scientific Reports, 13, Article No. 16242. [Google Scholar] [CrossRef] [PubMed]
[19] Li, X., Liang, W., Li, Z., Li, S., Zu, Y., Ge, L., et al. (2025) Neuromuscular Characteristics of Transcranial Direct Current Stimulation over Dorsolateral Prefrontal Cortex in Patients with Chronic Low Back Pain: A Randomized, Double-Blind, Controlled Trial Protocol. Frontiers in Human Neuroscience, 19, Article ID: 1586257. [Google Scholar] [CrossRef] [PubMed]
[20] Hazime, F.A., Baptista, A.F., de Freitas, D.G., Monteiro, R.L., Maretto, R.L., Hasue, R.H., et al. (2017) Treating Low Back Pain with Combined Cerebral and Peripheral Electrical Stimulation: A Randomized, Double‐Blind, Factorial Clinical Trial. European Journal of Pain, 21, 1132-1143. [Google Scholar] [CrossRef] [PubMed]
[21] Schabrun, S.M., Burns, E., Thapa, T. and Hodges, P. (2017) The Response of the Primary Motor Cortex to Neuromodulation Is Altered in Chronic Low Back Pain: A Preliminary Study. Pain Medicine, 19, 1227-1236. [Google Scholar] [CrossRef] [PubMed]
[22] Luedtke, K., Rushton, A., Wright, C., Jurgens, T., Polzer, A., Mueller, G., et al. (2015) Effectiveness of Transcranial Direct Current Stimulation Preceding Cognitive Behavioural Management for Chronic Low Back Pain: Sham Controlled Double Blinded Randomised Controlled Trial. BMJ, 350, h1640. [Google Scholar] [CrossRef] [PubMed]
[23] Baptista, A.F., Fernandes, A.M.B.L., Sá, K.N., Okano, A.H., Brunoni, A.R., Lara-Solares, A., et al. (2019) Latin American and Caribbean Consensus on Noninvasive Central Nervous System Neuromodulation for Chronic Pain Management (lac2-nin-cp). PAIN Reports, 4, e692. [Google Scholar] [CrossRef] [PubMed]
[24] Pinto, C.B., Teixeira Costa, B., Duarte, D. and Fregni, F. (2018) Transcranial Direct Current Stimulation as a Therapeutic Tool for Chronic Pain. The Journal of ECT, 34, e36-e50. [Google Scholar] [CrossRef] [PubMed]
[25] Chhatbar, P.Y., Chen, R., Deardorff, R., Dellenbach, B., Kautz, S.A., George, M.S., et al. (2017) Safety and Tolerability of Transcranial Direct Current Stimulation to Stroke Patients—A Phase I Current Escalation Study. Brain Stimulation, 10, 553-559. [Google Scholar] [CrossRef] [PubMed]
[26] Esmaeilpour, Z., Marangolo, P., Hampstead, B.M., Bestmann, S., Galletta, E., Knotkova, H., et al. (2018) Incomplete Evidence That Increasing Current Intensity of Tdcs Boosts Outcomes. Brain Stimulation, 11, 310-321. [Google Scholar] [CrossRef] [PubMed]
[27] Castillo-Saavedra, L., Gebodh, N., Bikson, M., Diaz-Cruz, C., Brandao, R., Coutinho, L., et al. (2016) Clinically Effective Treatment of Fibromyalgia Pain with High-Definition Transcranial Direct Current Stimulation: Phase II Open-Label Dose Optimization. The Journal of Pain, 17, 14-26. [Google Scholar] [CrossRef] [PubMed]
[28] Lefaucheur, J., Antal, A., Ayache, S.S., Benninger, D.H., Brunelin, J., Cogiamanian, F., et al. (2017) Evidence-Based Guidelines on the Therapeutic Use of Transcranial Direct Current Stimulation (tdcs). Clinical Neurophysiology, 128, 56-92. [Google Scholar] [CrossRef] [PubMed]
[29] Lefaucheur, J. (2016) Cortical Neurostimulation for Neuropathic Pain: State of the Art and Perspectives. Pain, 157, S81-S89. [Google Scholar] [CrossRef] [PubMed]
[30] Li, Y., Xie, H., Peng, J., Xu, Z., Fu, R., Cheng, X., et al. (2026) The Immediate Effect of Anodal Tdcs over the Motor Cortex on Postural Control and Cortical Activation in Patients with Chronic Low Back Pain: A Preliminary Study. Behavioural Brain Research, 496, Article ID: 115827. [Google Scholar] [CrossRef
[31] Bikson, M., Grossman, P., Thomas, C., Zannou, A.L., Jiang, J., Adnan, T., et al. (2016) Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016. Brain Stimulation, 9, 641-661. [Google Scholar] [CrossRef] [PubMed]
[32] Nikolin, S., Huggins, C., Martin, D., Alonzo, A. and Loo, C.K. (2018) Safety of Repeated Sessions of Transcranial Direct Current Stimulation: A Systematic Review. Brain Stimulation, 11, 278-288. [Google Scholar] [CrossRef] [PubMed]
[33] Matsumoto, H. and Ugawa, Y. (2017) Adverse Events of tDCS and tACS: A Review. Clinical Neurophysiology Practice, 2, 19-25. [Google Scholar] [CrossRef] [PubMed]
[34] Aparício, L.V.M., Guarienti, F., Razza, L.B., Carvalho, A.F., Fregni, F. and Brunoni, A.R. (2016) A Systematic Review on the Acceptability and Tolerability of Transcranial Direct Current Stimulation Treatment in Neuropsychiatry Trials. Brain Stimulation, 9, 671-681. [Google Scholar] [CrossRef] [PubMed]
[35] Paneri, B., Adair, D., Thomas, C., Khadka, N., Patel, V., Tyler, W.J., et al. (2016) Tolerability of Repeated Application of Transcranial Electrical Stimulation with Limited Outputs to Healthy Subjects. Brain Stimulation, 9, 740-754. [Google Scholar] [CrossRef] [PubMed]