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REVIEW

Vagus nerve stimulation for chronic pain management: Mechanisms and clinical advances

Milan Patel1 ,  Shahnaz Fooladi Sarabi2 ,  Kalvin Chen1 ,  Lukas J. Henjum1 ,  Barnabas T. Shiferaw1 ,  Danielle Kohr3 ,  Alaa Abd-Elsayed1*
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1 Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin 53706, United States of America
2 Department of Anesthesiology, Critical Care Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil 55136, Iran
3 Department of Pain Medicine, Tertiary Referral Clinic Löwenstein, Löwenstein, Baden-Württemberg 74245, Germany
JBM, e99010080 https://doi.org/10.14440/jbm.0051
Submitted: 21 April 2025 | Revised: 2 September 2025 | Accepted: 2 September 2025 | Published: 8 October 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Chronic pain poses a significant challenge to the general population, especially in older adults. As a result, there is a growing emphasis on developing novel treatment options and expanding the use of emerging technologies. Objective: This comprehensive review aims to guide practitioners in chronic pain management by extending the current application of vagus nerve stimulation (VNS). The review examined peer-reviewed studies, including multicenter cohort studies and clinical trials, published within the past 25 years. VNS has shown the most promising results in pain reduction for headache and migraine, with less relief in inflammatory and neuropathic pain as compared to current first-line treatment options. Conclusion: Overall, this review seeks to compile and critically analyze the effect and efficacy of VNS on different forms of chronic pain using the most current studies and research applicable.

Keywords
Chronic pain
Vagus nerve stimulation
Headache
Migraine
Inflammation
Neuropathy
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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