taVNS for Osteoarthritis

(taVNS Trial)

This trial explores how transcutaneous auricular vagus nerve stimulation (taVNS) can help manage pain and inflammation in veterans with knee osteoarthritis. It compares two different doses of taVNS with a standard corticosteroid injection (methylprednisolone acetate) to determine which best relieves knee pain. The goal is to identify an effective treatment plan that might complement future therapies. Veterans with knee osteoarthritis, who experience moderate to severe knee pain and can discontinue their current pain medications, might be suitable candidates for this trial. As an unphased trial, it offers veterans the opportunity to contribute to innovative research that could lead to new pain management solutions.

Research has shown that transcutaneous auricular vagus nerve stimulation (taVNS) is generally safe and well-tolerated. In studies, participants using taVNS for knee osteoarthritis (OA) reported only mild side effects, typically minor and occurring where the device contacts the skin. Additionally, taVNS may help reduce pain for those with OA.

Unlike the standard of care, which typically involves corticosteroid injections, taVNS (transcutaneous auricular vagus nerve stimulation) offers a unique approach to managing knee osteoarthritis pain. Researchers are excited about taVNS because it is a non-invasive, home-based therapy with minimal risk of side effects, making it more accessible and convenient for patients. This treatment works by targeting auricular vagal afferents to activate pathways in the central nervous system, including areas involved in pain processing, potentially reducing pain through anti-nociceptive effects. The ability to self-administer taVNS at home could significantly enhance patient comfort and compliance compared to more invasive options.

This trial will compare different treatments for knee osteoarthritis. One treatment arm involves transcutaneous auricular vagus nerve stimulation (taVNS), which research has shown can reduce knee pain in people with osteoarthritis. Studies found that taVNS lowered knee pain scores by about 1.27 points immediately after treatment and by about 1.87 points 15 minutes later. These findings suggest that taVNS might be a good option for pain relief. Additionally, taVNS is non-invasive and appears safe, with no serious side effects reported. While early results are promising, more research is needed to confirm its long-term benefits. Another arm of this trial will involve the standard-of-care corticosteroid injection (CSI) for managing knee osteoarthritis pain.¹²³⁶⁷