Review finds moderate-certainty evidence for low-frequency spinal cord stimulation in neuropathic pain

A systematic review and Bayesian network meta-analysis published in BMC Medicine compared the analgesic effects of neuromodulation techniques for neuropathic pain. Researchers searched five databases through July 1, 2025, identifying 115 randomized controlled trials evaluating 19 techniques. They assessed trial bias using the Cochrane Risk of Bias 2 tool and evidence certainty using the CINeMA framework.

Low-frequency spinal cord stimulation was identified as having substantial supporting evidence, with moderate certainty. Peripheral nerve stimulation, high-frequency spinal cord stimulation, radiofrequency thermocoagulation, dorsal root ganglion stimulation, and two pulsed radiofrequency approaches showed favorable analgesic effects, but evidence certainty was low. Non-invasive transcranial neuromodulation techniques showed limited analgesic benefits, also with low-certainty evidence.

The findings provide a comparative evidence overview rather than establishing a preferred technique for every neuropathic pain subtype. The supplied text does not report participant totals, numerical effect estimates, follow-up duration, or safety outcomes, limiting assessment of benefit magnitude and clinical trade-offs. Most favorable findings remain supported by low-certainty evidence. The authors reported no specific funding and declared no competing interests.