Purpose: Knee osteoarthritis (KOA) is highly prevalent and leads to marked pain and dysfunction. Abnormal central changes were associated with KOA and its symptoms. Repetitive transcranial magnetic stimulation (rTMS) may improve these changes. This study aimed to evaluate the effect of (rTMS) on pain severity in patients with chronic knee OA.

Methods: thirty female patients with chronic knee osteoarthritis with age ranged from 40-65 years, were enrolled from neurophysiology department, Kars Al-Ainy hospital randomly and equally assigned into two groups (A and B); group A (experimental group, n=15) received (rTMS) plus conventional treatment (active mobilization, strength building and stretching exercises), while group B (control, n=15) received conventional treatment only. Treatment was daily session for five consecutive days, followed by one session per week for four weeks. Patients were assessed for pain using visual analogue scale (VAS) and pain detect questionnaire (PDQ).

Results: There were statistically significant improvement in PDQ scores, post-treatment in both groups and VAS significantly improved in group B only (p-value<0.05). In addition, there were no-significant differences post-treatment between groups (p-value>0.05). However, higher clinical improvements were detected in group A.

Conclusion: Exercises with/out rTMS improved pain in patients with chronic knee OA. However, addition of rTMS induced higher clinical improvements.