Effects of transcranial direct current stimulation on patient-reported outcomes in chronic low back pain: a systematic review and three-level meta-analysis.
- 1Wuhan Business University, Wuhan, Hubei, China.
- 2Department of Rehabilitation Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
- 3School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
Abstract
Background
Growing evidence suggests that central nervous system alterations may contribute to the persistence of chronic low back pain (CLBP). Transcranial direct current stimulation (tDCS) can effectively modulate cortical excitability and holds considerable potential for the rehabilitation of CLBP. However, evidence regarding its effects remains controversial.Purpose
This study aimed to systematically evaluate the effects of tDCS on pain, disability, and psychosocial outcomes in individuals with CLBP.Methods
Five electronic databases were searched from their inception to January 20, 2026. Randomized controlled trials were included to evaluate the effects of tDCS in CLBP individuals. Meta-analysis was performed using the random-effects model implemented in the metafor package in R. Subgroup analyses were based on tDCS polarity, electrode placement, current intensity, treatment sessions, and comparison type.Results
A total of 14 randomized controlled trials were included. Meta-analysis results showed that compared with the control group, the tDCS group reported significantly reduced pain (standardized mean difference [SMD] = -0.40, 95% confidence interval [CI]: -0.61 to -0.19, P < 0.001) and disability (SMD = -0.18, 95 CI: -0.34 to -0.03, P < 0.02) in individuals with CLBP. However, no significant effects were observed for follow-up pain (SMD = -0.19, 95% CI: -0.46-0.08, P = 0.173), follow-up disability (SMD = -0.10, 95% CI: -0.26-0.05, P = 0.194), quality of life (SMD = 0.17, 95% CI: -0.08-0.41, P = 0.179), anxiety (SMD = -0.04, 95% CI: -0.23-0.15, P = 0.659), or depression (SMD = -0.18, 95% CI: -0.49-0.12, P = 0.241). Subgroup analyses based on tDCS polarity, electrode placement, current intensity, treatment sessions, and comparison type showed variations in effect estimates, but no significant between-subgroup differences were detected.Conclusion
Current evidence suggests that tDCS may reduce pain and produce a small improvement in disability in individuals with CLBP. Given the low-to-moderate certainty of the available evidence, these findings should be interpreted cautiously.Systematic review registration
identifier CRD420261286288.
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BibTeX
@article{wang2026effects,
title = {{Effects of transcranial direct current stimulation on patient-reported outcomes in chronic low back pain: a systematic review and three-level meta-analysis.}},
author = {Chenming Wang and Nianting Zhou and Sizhuo Zhang and Peng Chen},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1950897},
url = {https://europepmc.org/article/MED/42908585},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of transcranial direct current stimulation on patient-reported outcomes in chronic low back pain: a systematic review and three-level meta-analysis.
AU - Chenming Wang
AU - Nianting Zhou
AU - Sizhuo Zhang
AU - Peng Chen
PY - 2026
DA - 2026/10/07
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1950897
UR - https://europepmc.org/article/MED/42908585
AB - Background Growing evidence suggests that central nervous system alterations may contribute to the persistence of chronic low back pain (CLBP). Transcranial direct current stimulation (tDCS) can effectively modulate cortical excitability and holds considerable potential for the rehabilitation of CLBP. However, evidence regarding its effects remains controversial.Purpose This study aimed to systematically evaluate the effects of tDCS on pain, disability, and psychosocial outcomes in individuals with CLBP.Methods Five electronic databases were searched from their inception to January 20, 2026. Randomized controlled trials were included to evaluate the effects of tDCS in CLBP individuals. Meta-analysis was performed using the random-effects model implemented in the metafor package in R. Subgroup analyses were based on tDCS polarity, electrode placement, current intensity, treatment sessions, and comparison type.Results A total of 14 randomized controlled trials were included. Meta-analysis results showed that compared with the control group, the tDCS group reported significantly reduced pain (standardized mean difference [SMD] = -0.40, 95% confidence interval [CI]: -0.61 to -0.19, P < 0.001) and disability (SMD = -0.18, 95 CI: -0.34 to -0.03, P < 0.02) in individuals with CLBP. However, no significant effects were observed for follow-up pain (SMD = -0.19, 95% CI: -0.46-0.08, P = 0.173), follow-up disability (SMD = -0.10, 95% CI: -0.26-0.05, P = 0.194), quality of life (SMD = 0.17, 95% CI: -0.08-0.41, P = 0.179), anxiety (SMD = -0.04, 95% CI: -0.23-0.15, P = 0.659), or depression (SMD = -0.18, 95% CI: -0.49-0.12, P = 0.241). Subgroup analyses based on tDCS polarity, electrode placement, current intensity, treatment sessions, and comparison type showed variations in effect estimates, but no significant between-subgroup differences were detected.Conclusion Current evidence suggests that tDCS may reduce pain and produce a small improvement in disability in individuals with CLBP. Given the low-to-moderate certainty of the available evidence, these findings should be interpreted cautiously.Systematic review registration identifier CRD420261286288.
SN - 2296-858X
ER -