Effects of Transcranial Direct Current Stimulation and Individualized Physical Therapy on Pain and Function in Individuals With Chronic Knee Pain: A Pilot Study

Does adding transcranial direct current stimulation to individualized physical therapy improve pain and function more than sham — what this means stimulation in people with chronic knee pain?

30 adults with chronic knee pain treated in an outpatient orthopedic physical therapy setting

Pilot pragmatic triple-blind randomized — what this means sham — what this means-controlled trial; 5 sessions of real or sham tDCS each followed by individualized PT; follow-up — what this means beyond the treatment sessions not reported

• No between-group differences on the primary pain and function measures (NPRS, movement-evoked pain, CSI, 2-minute walk, 5x sit-to-stand, ROM, PSFS, LEFS)
• Real tDCS produced greater percent change in lateral joint line pressure pain threshold, plus a significant multivariate group effect across 3-site and 5-site PPT clusters (p < 0.05)
• In exploratory analysis, the real tDCS group had 12.8 times the odds of reaching the minimum detectable change for quadriceps strength (p < 0.05)

This small pilot points to possible mechanistic effects of tDCS on pain sensitivity and quadriceps strength but shows no advantage on patient-centered pain or function outcomes, so the evidence does not support routine use alongside PT for chronic knee pain.