Chronic pain is more common in the United States than you might think. Research shows that 20% of adults (about 50 million people) live with chronic pain, and almost 8% (19.6 million people) experience high-impact chronic pain that interrupts daily living.
While medications or physical therapies help many, a number of patients see little or no lasting relief. For those individuals, pain goes from being a symptom to being a condition.
The good news is there’s hope with transcranial magnetic stimulation. By targeting the brain’s pain-processing networks directly, TMS is a drug-free treatment that can reduce pain intensity and improve quality of life when conventional treatments aren’t enough.
What is Chronic Pain?
Chronic pain is pain that lasts or returns for longer than three months. Unlike acute pain that goes away after treatment, chronic pain continues even after the injury has healed. For many, it becomes its own condition rather than a symptom. The following can cause chronic pain:
- An existing injury
- Surgical complications
- Co-existing health conditions (diabetes or autoimmune disease)
- Genetic predisposition that increases pain sensitivity
- Poor sleep, inactivity, or high stress
Types of Chronic Pain
There are several types of chronic pain, each with its own symptoms:
- Arthritis and other joint-related pain
- Back pain
- Pain caused by cancer or cancer treatments
- Fibromyalgia
- Endometriosis and other gynecological pain issues
- Neurological conditions (multiple sclerosis)
- Migraine and chronic headache disorders
- Neck pain from degenerative or traumatic causes
- Neuropathic pain from damaged or misfiring nerves
Symptoms of Chronic Pain
While chronic pain involves ongoing discomfort, the symptoms aren’t always pain related. They can include:
- Insomnia or non-restorative sleep
- Fatigue and low energy
- Stiffness, soreness, or reduced mobility
- Burning or “pins and needles” sensations
- Headaches
- Secondary acute pain episodes
- Appetite changes
- Mood swings and irritability
- Strained family relationships and marriages
- Job loss or reduced hours
- Increased risk of substance misuse
Those with chronic pain are also at risk for experiencing mental health conditions, with one study finding 60% of chronic pain patients met the criteria for an anxiety disorder. This shows just how much of an impact pain can have on an individual.
Chronic Pain and the Brain
For many years, doctors saw pain as a symptom of another condition that could improve once the underlying disease or injury was treated. Yet many people continue to feel pain long after the body has healed, suggesting that pain may actually come from another part of the body: the brain.
Pain doesn’t exist until the brain processes it. When nerves in the body detect an injury, they release chemicals that send warning signals up the spinal cord. Those signals arrive at the thalamus, a part of the brain that acts like a traffic controller and decides where to send the information next. Other brain regions then interpret those signals and turn them into the feeling of pain.
How strongly someone feels pain depends on more than signals, however. The brain uses:
- Genetics, which can make some people more sensitive to pain
- Past experiences, including memories of injury or trauma
- Strong emotions like fear or stress, which can intensify pain perception
- Environments, like feeling more pain when alone versus supported
With chronic pain, the brain’s perception system becomes overly sensitized. This means that normal signals may be interpreted as ongoing pain.
How Does TMS Work for Chronic Pain?
Transcranial magnetic stimulation, or TMS, is a non-invasive therapy that uses magnetic pulses to stimulate specific areas of the brain. Instead of working on the body where pain is felt, it changes how the brain processes and responds to pain signals.
When repetitive TMS (rTMS) is applied:
- It helps calm overactive pain pathways in the brain so signals aren’t interpreted as strongly.
- It activates the brain’s brake system, or neural circuits, to turn down the volume on pain messages traveling from the body.
- It strengthens connections that make it easier for the brain to regulate discomfort over time.
Research shows that by retraining these systems, rTMS can reduce the intensity and frequency of chronic pain, even when the original injury or condition has already been treated.
Benefits of TMS for Chronic Pain
One of the best benefits of TMS is that it’s delivering more than short-term pain relief. Studies show it can improve physical and emotional symptoms in those living with chronic pain. Here are some benefits:
- Pain reduction: 10Hz rTMS can cut pain intensity by 20-50% in many patients.
- Mental health: rTMs has been found to lower depression and insomnia symptoms that often come with chronic pain.
- Better daily functioning: As pain decreases, patients report improved mobility, energy, and quality of life.
- Drug-free: TMS doesn’t require sedation or ongoing medication.
Reduced dependence on pain medications: Patients using opioids alongside TMS report fewer cravings and less disruption from pain.
Limitations and Risks
TMS is considered safe for most people, but like any treatment, it’s not without its risks. Mild and temporary side effects are possible and may include headache, tingling on the scalp, facial twitching, or jaw discomfort. However, these usually resolve within hours and respond to over-the-counter pain relievers. Seizures occur in less than 1% of patients.
Additionally, some types of pain, or patients with certain medical conditions, may not respond as strongly to TMS. In these cases, your doctor will work with you to adjust your treatment plan in a way that best works for you.
TMS vs. Other Pain Treatments
Chronic pain can be managed in many ways, from medications to physical therapy. Each option has its strengths and drawbacks, and in some cases, they may even be used alongside TMS for better results.
Medications
Pain medications are common in pain management and include over-the-counter drugs and stronger prescriptions. However, while they can relieve symptoms, they also come with ongoing side effects or a risk of addiction.
A study comparing medications to TMS found that 40% of patients found relief and 20% modest relief with rTMS, while opioids helped only 30% of patients. Opioids also carry a 78% adverse event rate and a high risk of dependence or overdose.
Physical Therapy
Physical therapy (PT) strengthens muscles, improves flexibility, and retrains movement. It can be effective, but results often take time, and symptoms may worsen before they improve. TMS may enhance the benefits of PT when used together:
- rTMS calms overactive pain circuits in the brain.
- PT then uses this reset to retrain muscles and restore movement.
In stroke rehabilitation, this combination has led to improved walking ability, better coordination, and less spasticity.
Acupuncture
Acupuncture has been used for centuries to manage pain by stimulating specific pressure points on the body. On its own, results can vary, but pairing it with TMS may be promising. Research shows that acupuncture combined with rTMS is more effective than either treatment alone for improving motor function, daily living ability, and neurological recovery after stroke.
What to Expect During a TMS Session for Pain
After an initial evaluation, your doctor will create a TMS treatment plan based on your symptoms and overall health. Then, you’ll start treatment, which may look similar to this:
- Step 1: Preparation
Patients sit comfortably in a chair, awake and alert. No anesthesia or sedation is required.
- Step 2: Placement
A technician positions a magnetic coil against the scalp over the area being targeted for pain relief.
- Step 3: Stimulation
The machine delivers short bursts of magnetic pulses. These feel like tapping or mild knocking on the head and may cause small muscle twitches in the face or jaw.
- Step 4: Monitoring
Throughout the session and full treatment, staff will monitor your comfort levels and adjust settings as needed.
A typical session will last around 20-40 minutes depending on your treatment plan. Most patients undergo sessions several times per week for a set number of weeks. You can also return to normal activities following your session.
Begin Your Journey to Wellness with Pulse TMS
Chronic pain treatment relies on medications, physical therapy, or other approaches, but these don’t always bring the relief you’re looking for. TMS offers a new way forward by directly changing how the brain processes pain. For many, it means fewer pain days, better sleep, and less reliance on medication.
At Pulse TMS, we bring advanced TMS treatment together with attentive, personalized care. Our goal is to make every session effective and comfortable, so patients can focus on regaining control of their health. Schedule your consultation today and experience a higher standard of pain management.
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