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This is a single-site, randomized, Single-blinded, placebo-controlled, trial of Transcutaneous Magnetic Stimulation (TCMS) for the treatment of lower back pain. TCMS will be applied locally to the back in the location of a patient's pain.
Approximately one third of Americans suffer from acute and chronic pain and pain has been called a silent epidemic. Treatment of pain often involves opioid medications with a significant potential for abuse, addiction and adverse reactions such as respiratory depression and death. Magnetic brain stimulation has been used for the treatment of pain. There are reports of its use in phantom-limb pain and in the treatment of central and peripheral pain syndromes.
The study will evaluate whether an experimental medical device (Fischell TCMS Pain Treatment Device) that emits pulses of a brief, intense magnetic field will relieve pain in the lower back. Transcutaneous Magnetic Stimulation (TCMS) is the name of this method of delivering magnetic pulses through the skin. TCMS has been approved by the FDA for peripheral nerve stimulation, treatment of migraine headaches and for depression but this type of device has not been studied scientifically for the treatment of back pain. No significant adverse reactions or side effects have been reported with the use of magnetic stimulation for headache treatment. Some patients who have migraine headaches have excellent pain relief with the magnetic treatment even if they do not get pain relief with medications. Other patients do not have headache relief with magnetic treatment. The current use of TCMS applied to the head requires special equipment and multiple treatment sessions. TCMS applied peripherally is easier to do, and may require fewer treatment sessions to achieve pain relief. Non-invasive treatment of pain would represent a significant advance in the field especially if its use both successfully treated pain and resulted in the reduction or elimination in the need for opioid medications.
The investigators do not know whether magnetic treatment will relieve back pain so the investigators will test this by applying a powerful electromagnet to the area of the back having pain. In some patients, the magnet will be turned on, but in other patients the magnet will not be turned on. Neither patients nor patient's treating doctor will know whether the magnet was turned on or not, although the study team will know which patients received treatment with magnetic pulses. The effect on pain will be recorded periodically for 2 days. If the patients' reported pain is reduced by having the magnet turned on compared to patients' who do not have the magnet turned on, then the magnet may have reduced the pain. Additional studies in patients will be needed to be sure that the magnet therapy is reducing low back pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transcutaneous Magnetic Stimulation | Experimental | Transcutaneous Magnetic Stimulation |
|
| Sham Device | Placebo Comparator | Sham Device |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fischell Transcutaneous Magnetic Stimulation Pain Treatment Device | Device | Transcutaneous Magnetic Stimulation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Immediate Pain Measured by Numeric Pain Rating Scale (NPRS) | Immediate relief measured by Numeric Pain Rating Scale (NPRS) Scale from 0-10 0=No pain 10= Worse possible pain | 60 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Durable Pain Measured by Numeric Pain Rating Scale (NPRS) | Durable pain relief measured by Numeric Pain Rating Scale (NPRS) 0= No pain 10= Worse imaginable pain | 30 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Peter Rock, MD | University of Maryland, Baltimore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| La Toya Stubbs | Baltimore | Maryland | 21201 | United States |
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Patients who agreed to participate were provided with a pain diary and were instructed to document their average pain each day for a week using the Numeric Pain Rating Scale (NPRS) to establish their baseline level of pain. Patients were also given the Global Pain Scale (GPS) to complete and return on the day of treatment.
Recruited at the Pain Management Center at University of Maryland Rehabilitation & Orthopaedic Institute from 8/22/2016-4/27/2017.
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| ID | Title | Description |
|---|---|---|
| FG000 | Transcutaneous Magnetic Stimulation | Transcutaneous Magnetic Stimulation Fischell Transcutaneous Magnetic Stimulation Pain Treatment Device: Transcutaneous Magnetic Stimulation |
| FG001 | Sham Device | Sham Device Placebo: The placebo Transcutaneous device |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Transcutaneous Magnetic Stimulation | Transcutaneous Magnetic Stimulation Fischell Transcutaneous Magnetic Stimulation Pain Treatment Device: Transcutaneous Magnetic Stimulation |
| BG001 | Sham Device |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Immediate Pain Measured by Numeric Pain Rating Scale (NPRS) | Immediate relief measured by Numeric Pain Rating Scale (NPRS) Scale from 0-10 0=No pain 10= Worse possible pain | Posted | Mean | Full Range | score on a scale | 60 minutes |
|
We collected information on adverse event data during the enrollment period of 30 days.
This study had no risk of mortality
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Transcutaneous Magnetic Stimulation | Transcutaneous Magnetic Stimulation Fischell Transcutaneous Magnetic Stimulation Pain Treatment Device: Transcutaneous Magnetic Stimulation |
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The population of patients (chronic pain) proved to be difficult to get in for treatment and follow-up. This lead to small enrollment numbers.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Peter Rock | University of Maryland School of Medicine | 410-328-6933 | prock@som.umaryland.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 25, 2016 | Mar 13, 2020 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| Placebo | Device | The placebo Transcutaneous device |
|
|
Sham Device
Placebo: The placebo Transcutaneous device
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Units | Counts |
|---|
| Participants |
|
|
| Secondary | Durable Pain Measured by Numeric Pain Rating Scale (NPRS) | Durable pain relief measured by Numeric Pain Rating Scale (NPRS) 0= No pain 10= Worse imaginable pain | Posted | Mean | Full Range | score on a scale | 30 days |
|
|
|
| 0 |
| 11 |
| 0 |
| 11 |
| 0 |
| 11 |
| EG001 | Sham Device | Sham Device Placebo: The placebo Transcutaneous device | 0 | 9 | 0 | 9 | 0 | 9 |
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| D013568 |
| Pathological Conditions, Signs and Symptoms |