IMPROVEMENT OF NEUROPATHIC PAIN AND FUNCTIONAL AUTONOMY IN ADVANCED MULTIPLE SCLEROSIS THROUGH EQUISTASI® TREATMENT: A SIX-MONTH CASE REPORT

M. Alfieri¹, V. Donatiello¹, D. Casale², F. Mattozzi¹, A. Cangiano¹, V. Moschella¹, P. Buonavolont๠| ¹UOSD Terapia del Dolore AORN "A. Cardarelli", Napoli, Italy; ²UOC Anestesia e Terapia Intensiva PO "Santa Maria della Pietà", Nola, Italy

Introduction. Neuropathic pain is a frequent and disabling symptom in patients with multiple sclerosis (MS), significantly impairing quality of life and functional independence. Despite the availability of several pharmacological treatments, a substantial proportion of patients remain refractory to conventional therapies. Equistasi® is a wearable vibrotactile medical device composed of nanotechnological fibers capable of converting body heat into focal mechanical vibrations. These vibrations are thought to modulate proprioceptive input and sensorimotor integration, potentially improving balance, gait performance, and neurological symptoms in patients with neurodegenerative disorders (Gandolfi et al., 2015; Petrarca et al., 2018). Emerging evidence also suggests a possible beneficial effect on pain perception through modulation of central sensory processing.
Case Report. A 68-year-old man with a history of multiple sclerosis diagnosed more than 10 years earlier was referred to our Pain Medicine Center of AORN “A. Cardarelli”, Naples for severe neuropathic pain predominantly affecting both lower limbs. During the previous two years, the patient had experienced a marked clinical deterioration characterized by progressive functional impairment, reduced mobility, and worsening neuropathic pain. At presentation, he was receiving gabapentin 300 mg three times daily. Previous treatment attempts with the main pharmacological options commonly employed for neuropathic pain had provided insufficient relief or had been poorly tolerated. Considering the refractory nature of his symptoms and the progressive decline in functional status, treatment with Equistasi® was proposed. The device was applied according to the manufacturer's recommendations and used continuously during the observation period, while the ongoing pharmacological therapy remained unchanged. After six months of treatment, the patient reported a clinically meaningful reduction in neuropathic pain intensity in both lower limbs. Furthermore, a substantial improvement in functional autonomy was observed, with enhanced mobility and greater independence in activities of daily living. No adverse events related to the device were reported. The patient expressed valid informed consent for the publication of his clinical data and for the dissemination of the present abstract.
Conclusion. This case suggests that Equistasi® may represent a valuable non-pharmacological adjunctive treatment in patients with advanced multiple sclerosis and refractory neuropathic pain. In addition to reducing pain intensity, the intervention was associated with improved functional autonomy and mobility. Although the underlying mechanisms require further investigation, proprioceptive neuromodulation through focal vibrotactile stimulation may offer a promising therapeutic strategy for complex neurological patients who have limited benefit from conventional analgesic treatments. Larger prospective studies are warranted to confirm these preliminary observations.