TMS with Neuronavigation › Neuropathic pain
Burning, stabbing, electric. And medication has not been enough.
Transcranial magnetic stimulation (TMS) of the motor cortex activates the brain’s own pain-control system. For pain that burns, stabs or feels electric and has not responded to medication.
How patients describe it
If these words sound familiar and the pain has lasted for months, a consultation with a neurologist is worthwhile.
Why it hurts
In neuropathic pain, the problem is no longer only where it hurts. The nervous system stays “set” to pain: the brain amplifies the signals and can no longer switch them off as before. That is why ordinary painkillers are sometimes not enough.
1 · The injury
A nerve has been damaged
Shingles, diabetes, surgery, nerve compression or a spinal cord injury.
2 · Amplification
The brain stays on alert
Pain signals are amplified, and the brain’s own pain-control system works less well.
3 · TMS
We reactivate pain control
Stimulating the motor cortex activates the networks through which the brain dampens pain itself.
Which forms we treat
At the consultation, the neurologist tells you how strong the evidence is for your form of pain, so you know what to expect.
Post-herpetic neuralgia
The pain that remains after shingles. It has the most consistent results of the peripheral forms.
Pain after nerve or spinal cord injury
Central or peripheral neuropathic pain, including after surgery or trauma.
Diabetic neuropathy
Studied, but with more variable results. The neurologist discusses with you at the consultation what you can expect.
Fibromyalgia
Widespread pain and fatigue. A separate protocol, for pain or for quality of life.
What studies show
Level A
definite efficacy
Stimulating the motor cortex on the side opposite the pain has the highest level of recommendation in the European TMS guidelines.
Source: Lefaucheur et al., Clinical Neurophysiology, 2020 (European TMS guidelines)
large effect
in 9 randomised studies
A 2026 meta-analysis of 435 patients found a large reduction in pain intensity compared with placebo stimulation.
3 months
lasting effect in post-herpetic neuralgia
In pain after shingles, TMS reduced pain by about 2 points on the 0–10 scale, and the effect was still visible at 3 months.
5–10
sessions to start
A short course of one session a day, followed by maintenance sessions that keep the effect going.
A short course to start, then maintenance sessions, because the effect on pain lasts better this way.
Once
Consultation with the neurologist
Neurological assessment and standardised pain scales.
First day
Motor threshold and target
We find the motor cortex area from the hand’s response to stimulation.
1–2 weeks
5–10 sessions
One session a day, about 15 minutes each.
Then
Maintenance
Periodic sessions, set according to how the pain develops.
What the neurologist checks at reassessment
In brief, with Dr Nadia Gorduza
Dr Nadia Gorduza explains why neuropathic pain is also treated from the brain and what a course of TMS looks like.
If you have diabetes
Painful diabetic neuropathy can be treated with TMS as an add-on to your current treatment. The evidence is more variable than for pain after shingles, so the neurologist tells you at the consultation what you can expect.
Ongoing research
The international clinical trials registry (ClinicalTrials.gov) lists 13 ongoing TMS studies in neuropathic pain, many not yet published. Here are some of them:
Saint-Étienne University Hospital, France · 60 patients
Neuropathic pain and depression together
Compares motor cortex stimulation with prefrontal stimulation in patients who have both pain and depression.
Saint-Étienne University Hospital, France · 60 patients
Neuropathic pain in patients with cancer
Tests motor cortex TMS for cancer-related neuropathic pain, where medication often has limits.
Zhejiang University, China · 120 patients
Accelerated Theta Burst for pain
Tests whether an intensive course over a few days can relieve neuropathic pain faster.
Saint-Étienne University Hospital, France · 64 patients
TMS and mirror therapy in virtual reality
Combines stimulation with virtual reality exercises for a stronger pain-relieving effect.
Launch prices
Launch prices. We usually use TMS Standard: the target is found from the motor response, without an MRI or 3D model.
TMS Standard
250 lei / session
Optional, on the neurologist’s recommendation
The Neuronavigation option
With a 3D brain model, from 300 lei per session, or on your own MRI, from 360 lei per session. The MRI is done separately, at a centre of your choice.
See all options →Good to know
The effect builds during the course and is maintained with maintenance sessions, at a frequency set by the neurologist.
It may be an option. Painful diabetic neuropathy is one of the forms of neuropathic pain in which TMS has been studied, but results are more variable than, for example, in pain after shingles. At the neurological consultation we discuss what you can expect in your case. TMS is added to your current treatment.
Eat before every session and, if you take insulin, check your blood sugar. Low blood sugar increases the risk of side effects, so tell us if you have had hypoglycaemia. Also let us know if you have an insulin pump or a glucose sensor.
The device is far from the stimulated area, but in patients with cardiac devices treatment starts only with the cardiologist’s written approval, after the consultation with the neurologist.
Yes. TMS is usually given in addition to your current treatment, and the neurologist can adjust your medication as the pain eases.
The most consistent evidence is for neuropathic pain, especially after shingles. At the consultation, the neurologist tells you what results are realistic in your case.
The first step is a consultation with the neurologist. Tap “Book now!” and choose your time directly on WhatsApp. Bring your medical records, your list of medications and your MRI, if you have one.
3 Aviator Jean Texier Street, 1st floor, apt. 2, Sector 1, Bucharest · Monday–Friday, 10:00–20:00
Results vary from patient to patient. The indication for TMS is set by the neurologist after a consultation. Sources: Lefaucheur et al., Clin Neurophysiol 2020 · J Pain Res 2026 · Neuromodulation 2026 · ClinicalTrials.gov, November 2026 · Academy of Brain Stimulation, TMS Protocols 08/2026.
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