Recruiting

TMS

Sponsor:

Joe X. Zhang

Code:

NCT07652944

Conditions

Lower Back Pain Chronic

Eligibility Criteria

Sex: All

Age: 18 - 64

Healthy Volunteers: Not accepted

Interventions

peripheral magnetic stimulation

Home exercise

Study Details

Brief summary:

The goal of this study is to see if a new way to treat back pain without the use of medications is effective. We plan use Transcranial Magnetic Stimulation (TMS), a wand-like device, to excite the nerves of people with lower back pain to see if we can decrease pain and improve quality of life.

This study will have two groups and randomly assign participants to a group. One group will have their back nerves stimulated with the TMS device and the other group will not.

Participants will also need to do back exercises at home once a day, and complete questionnaires at each visit before and after each treatment. The total time commitment will be 5 to10 visits with one visit occurring each weekday and each visit lasting up to 30 minutes.

Conditions

Lower Back Pain Chronic

Study ID

NCT07652944

Start date

Jul, 2026

Status verified date

May, 2026

Completion date

Feb, 2027

Anticipated

Primary completion date

Nov, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 64

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Diagnosed with chronic low back pain (greater than or equal to 12 weeks) with or without concurrent neck pain.
  • Low back pain in the paraspinal region (L1-S2) by asking the patient to point to their area of pain.
  • 18 - 64 years old (on the day of informed consent)
  • Willing and able to attend all study visits.
  • No medication changes for at least 30 days before study enrollment (self-report)
  • Eligible for care at participating military treatment facilities
  • Able to read and understand English.
  • Negative pregnancy test for women capable of pregnancy.

Exclusion Criteria:

  • Diagnosed with low back pain of less than 12 weeks duration
  • History of back fractures or surgical repair of the back
  • History of depression with vagus nerve stimulation
  • Any type of transcranial magnetic stimulation (TMS), or rPMS treatment prior to study enrollment.
  • Currently using any other adjunctive treatments for chronic back pain such as low-level laser treatment, ultrasound, dry needling, chiropractor manipulations, cervical collars, TENS units, or other stimulation, eastern medicine regimens including Qi Gong or Tai Chi. (Exception: strength building physical therapy, non-neuropathic pain modifiers, and non-anticonvulsant routine pain medicine regimens such as NSAIDS and Acetaminophen are allowed).Scheduled for nerve ablation, dry needling, trigger point injections, nerve block, therapeutic ultrasound, other stimulation, or similar adjunct treatments during the study period.
  • Diagnosed with a specific low back pain: osteoarthritis, rheumatoid arthritis, phantom limb pain, central pain syndrome, spinal cord damage, myofascial pain syndrome, or other more specific diagnosis (at investigators discretion).
  • Unstable or poorly controlled mental health diagnosis (e.g., current changes in medication or medical management).
  • Dermal or subdermal implants (e.g., aneurysm clips, shunts, stimulators, ferro magnetic implants, stents, or electrodes, or pacemakers) or any other metal object within or near the site of stimulation which cannot be safely removed.
  • Clinically significant abnormality or clinically significant unstable medical condition that, in the investigator's judgment, might pose a potential safety risk to the subject or limit interpretation of the trial results.
  • Any condition which, in the judgment of the investigator, would prevent the patient from completing study procedures.
  • Pregnancy
  • Younger than 18 years old (on the day of informed consent)
  • Older than 64 years old (on the day of informed consent)
  • NOT willing or able to attend all study visits.
  • Medication changes for back pain less than 30 days prior to study enrollment (self-report)
  • NOT eligible for care at participating military treatment facilities
  • NOT able to read and understand English.

Study Design

Enrollment

88 participants

Anticipated

Allocation

Randomized

Intervention Model

Crossover

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Treatment Arm

Individuals in this arm receive magnetic stimulation to the area of the lower back where they have pain from sessions 1 through 5. We begin stimulation operation at 20% advancing in 5% increments to maximum of 35% machine power which in our case is approximately 0.3 tesla to 0.58 tesla of power (a typical outpatient MRI is 1.5 to 3 tesla). The power of the unit will be titrated up to the maximum 35% based on patient tolerance by asking participants to "Tell me if you feel a painful muscle contraction". Patients receiving active therapy would be able to feel the stimulus usually described as a vibration sensation. If patients report painful muscle contractions, stop and go back by 5%. Doing this helps ensure that we would not cause any potentially painful muscle contractions and avoid confounding our test data. The first treatment will start at 20% power then increase by 5% until the titrated power level is identified, subsequent treatments will start at the power level last used.

sham comparator: Sham Arm

The investigators will configure the rPMS device to not utilize any power, then place the treatment wand over the participant's back pain area and hit the start button like they do in the treatment arm. When the power setting is set to zero, the magnetic wand will not generate any power but will still make the customary computer-generated tones as it does in normal operation. The device is set to play a completed tone once 2 minutes and 30 seconds have elapsed just as it does in the normal treatment. The investigator will then replace the wand back to the storage position and notify the patient that the session is completed.

Following completion of 5 sessions, the sham group will be offered to receive up to 5 sessions of real rPMS stimulation. The data from the sham treatment and real rPMS treatment for these patients will be tracked separately.

Interventions

peripheral magnetic stimulation

Our stimulation protocol is ssing approximately 0.3 tesla to 0.58 tesla of magnetic power using a variable stimulation frequency between 11ms and 14ms with center value of 13ms between pulses. This translates to estimated values of lower bounds of 71.43 Hz, central value of 83 Hz, and maximum value of 99 Hz .

Home exercise

All patients will receive a home exercise guide and recommended to perform the stated number of repetitions of those exercises. Exercises include Neutral Curl Up with Straight Leg, Plank on Elbow, and Bird Dog positions.

Primary outcome measure

  • Visual Analog Scale [ Time Frame: VAS numbers are obtained at: Baseline, pre-intervention. Immediately before each intervention Immediately after each intervention ]

Central Contacts and Locations

Central contacts

Joe Zhang, MD

415-619-9997joe.x.zhang.mil@health.mil

Joshua Ford, PhysD

661-275-5057joshua.c.ford21.mil@health.mil

Locations

412 Medical Group

Recruiting

Edwards Air Force Base, California, United States, 93524

More Information

Sponsor

Joe X. Zhang

Last update posted

Jun 17, 2026

Last verified

May, 2026

Keywords

  • magnetic stimulation
  • lower back pain
  • rPMS
  • HiVE
  • repetitive peripheral magnetic stimulation

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Joe X. Zhang on 2026-06-17.