Auricular Vagus Nerve Stimulation in Painful and Inflammatory Erosive Hand Osteoarthritis

Inclusion Criteria: * Age ≥ 18 years * Symptomatic HOA according to the American College of Rheumatology criteria * Erosive HOA according to hand radiographs performed in routine practice showing ≥1 erosive digital joint based on Verbruggen-Veys scoring definition * Hand pain level ≥ 40/100 mm on VAS at inclusion at least half of days of the 30 last days * At least ≥1 symptomatic IP joint with clinical soft swelling or erythema at inclusion * reported inadequate response or adverse effects or contraindication with existing medication (including acetaminophen, oral NSAIDs) * Informed written consent * Patient affiliated to a social security scheme NB: Clinical inflammation, ultrasound abnormalities and radiographic erosions have not have to be present in the same joint. Exclusion Criteria: * Isolated thumb-base OA (i.e., rhizarthrosis) * Predominance of the pain in the thumb base rather than digital pain * Other inflammatory joint disease (e.g. gout, reactive arthritis, rheumatoid arthritis, psoriatic arthritis, Lyme disease) * Psoriasis * Current skin disease of the left ear (e.g., eczema, urticarial lesion, skin infection, external otitis) * Ear canal not adapted to apply the auricular electrode * Known history of cardiac rhythm disturbances, atrio-ventricular block \> first degree, or total bundle branch block * Symptomatic orthostatic hypotension or repeated vasovagal syncope history * History of vagotomy * Severe Asthma * Treated sleep apnea * Existence of a pain syndr…