Neuropathic Pain

Acute pain is a normal sensation triggered in the Nervous System (NS) in order to warn us about possible injuries and to take care of ourselves.

Dolor Neuropático

Chronic pain is different, it is persistent. Pain signals continue to shoot permanently in the NS for weeks, months or even years.

There may be an acute trigger, such as cervical pain or rib trauma, or there may be a permanent cause of pain such as tumor, arthritis or a degenerative process. Some other people can suffer from chronic pain without previous injuries or evidence of strange elements.

Other forms of chronic pain are neurogenic pain (pain resulting from damage to peripheral nerves or the central nervous system itself), and psychogenic pain (pain not due to illness or injury, or any sign of visible damage inside or outside the NS). The common cause capable of producing these types of pain is unknown.

Medicines, acupuncture, local and brain stimulation, as well as surgery, are some of the proposals for chronic pain. Placebos sometimes provide some benefit or even eliminate pain. Psychotherapy, relaxation, biofeedback, and behavior modification techniques are also used to deal with pain.

Many patients can be helped by understanding all the causes of their pain, with different alternatives to undo what chronic pain has produced.

In various clinical research studies, low levels of endorphins have been discovered in the cerebrospinal fluid. Acupuncture and electropuncture activate the levels of endorphins. Other scientists are willing to find out the effect of stress on chronic pain. Chemists are synthesizing new molecules and discovering analgesic effects in medications not prescribed for pain.

Certain neurosurgical techniques are successfully used to treat resistant neuropathic pain including deep brain stimulation of the motor cortex or epidural cortex.

Painful neuropathy is associated with changes in the plasticity of the NS. Thus, pain induces plasticity in the motor cortex and activates inhibitory systems for the control of descending pain.

Dolor Neuropático

Through deep TMS cortical excitability is modulated and the brain perception of pain is inhibited without manipulating deep regions of the brain. Studies examined the effect of stimulation on pain sensation and the nociceptive flexion reflex RIII jointly in patients suffering from neuropathic pain induced by diabetes (Guirimand et. al., 1999).

Treatment through deep TMS is an effective alternative that alleviates this insidious symptom that conditions the patient´s quality of life. It is a hopeful complement to current medicines.

The BrainsWay H10- Coil allows deep brain stimulation without significantly increasing the induced fields in the superficial areas of the cortex. Therefore, this coil can be used to stimulate the motor cortex of the lower limbs in the central sulcus, a region of the brain hidden deep 3 or 4 cm in the interhemispheric fissure.

It is a secure and non-invasive technique to treat chronic pain, very effective in diabetic neuropathy. Magnetic stimulation of brain structures and networks associated with chronic pain contributes to an important relief. It is a procedure that does not require the patient to be hospitalized since there is no surgery or anesthesia needed, nor postoperative recovery. It is very well tolerated and the side effects are incidental.

The use and permanent contact during 11 years with superficial TMS, guarantee the best management of deep TMS.

At the end of October 2013, the treatment for neuropathic pain with dTMS was approved by EMA for its safety, reliability and effectiveness.


At our Neuromodulation Unit, we often observe two simultaneous pathologies in the same patient, known as Dual Pathology, which forces us to resort treatments with different helmets and even recommend invasive techniques.

The deep TMS is the most advanced, versatile and currently available system in the field of NEUROMODULATION, as it exceeds superficial systems by:

  • The design of the coils and their coupling to specific padded helmets
  • The ability to adjust the helmet to the head morphology, ensuring that energy pulses are systematically received in repetitively selected target circuits, rather than exclusively cortical nodes.
  • The measurements and external cranial marks that contribute and allow the correct alignment and immobilization of the head without distortions, increasing the efficiency of the treatment.