Author(s)

Rafael Giovani Missé¹, Lucas De Macedo Dos Santos², Clarice Tanaka², Abrahão Fontes Baptista^2,3, Samuel Katsuyuki Shinjo^1*

¹Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
²Department of Physical Therapy, Speech Therapy, and Ocupacional Therapy, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
³Center for Mathematics, Computing, and Cognition, Universidade Federal de ABC, Sao Paulo, Brazil.

Background: Transcranial direct current stimulation (tDCS) has emerged as an adjuvant noninvasive neuromodulation tool to control fatigue and pain. To date, no studies have assessed the safety and efficiency of tDCS in patients with rheumatoid arthritis and with fatigue, poor quality of life, and refractory radicular pain associated with spinal stenosis. Case Presentation: An 85-year-old woman patient presented with rheumatoid arthritis in remission, refractory radicular pain-associated spinal stenosis, fatigue, and impaired quality of life. The patient underwent 16 daily sessions of tDCS intervention (2 mA, 20 min, positively and negatively charged electrodes were positioned at C1 and Fp2, respectively), in addition to simultaneous peripheral neuromuscular electrical stimulation (frequency of 100 Hz and amplitude of 500 μs). After the intervention, neither disease relapse nor clinical intercurrence occurred. Moreover, there was a significant and sustained improvement in her health-related quality of life, with a reduction in the level of pain and chronic fatigue. Conclusion: The present case report shows that tDCS is safe and may be an adjuvant tool for the treatment of pain and fatigue in patients with systemic autoimmune disease, as well as for improving quality of life. Further studies are required to corroborate this case report.

Neuromodulation, Pain, Radiculopathy, Rheumatoid Arthritis, Treatment

Missé, R. , Santos, L. , Tanaka, C. , Baptista, A. and Shinjo, S. (2023) Transcranial Direct Current Stimulation Combined with Peripheral Neuromuscular Stimulation Improves Quality of Life, Fatigue, and Pain in a Patient with Rheumatoid Arthritis and Refractory Radicular Pain Related to Spinal Stenosis. Open Journal of Rheumatology and Autoimmune Diseases, 13, 1-7. doi: 10.4236/ojra.2023.131001.