Transcutaneous Auricular Vagus Nerve Stimulation for Chronic Pain Management: A Narrative Review.

Abstract

Chronic pain represents a global public health challenge; current therapeutic interventions remain limited and are frequently accompanied by adverse effects. Transcutaneous auricular Vagus Nerve Stimulation (taVNS) has emerged in recent years as a potential non-invasive neuromodulation therapy, providing novel possibilities for chronic pain management. Preliminary research indicates that taVNS demonstrates preliminary therapeutic potential in conditions such as migraine, fibromyalgia, and chronic low back pain, with initial exploratory applications also conducted in trigeminal neuralgia, diabetic peripheral neuropathy, and persistent abdominal pain. Multiple studies suggest that this modality can effectively attenuate pain intensity and enhance patients' quality of life. The underlying analgesic mechanisms are likely associated with modulation of the locus coeruleus-noradrenergic system, the prefrontal cortex-dopaminergic system, and autonomic nervous system function, as well as the suppression of inflammatory responses. Although current evidence suggests that taVNS may be a safe and effective adjunctive therapy, future high-quality, large-scale, and longitudinal studies are imperative to establish standardized stimulation parameters and confirm long-term clinical benefits.