Peripheral Nerve Stimulation

Peripheral nerve stimulation (PNS) is an emerging method of treating chronic and neuropathic pain that has seen exciting results in recent years. In principle, it is similar to a well-known procedure called a spinal cord stimulator (SCS). Both treatments use a wire of electrodes placed in the body to “disrupt” the ability of nerves to send pain signals to the brain. Where they differ is in the placement of the electrodes.

The SCS wire is placed alongside the spinal cord and blocks part of the central nervous system, but PNS adopts a more targeted approach by placing the stimulator wire near a nerve in the arm, leg, abdomen or other area to relieve pain. As the name indicates, the wire is placed under the skin elsewhere in the body (by peripheral, we simply mean away from the spinal cord) to disrupt pain signals at the specific site the patient experiences pain.

Peripheral nerve stimulation is most commonly recommended for patients in which SCS is inappropriate for any reason, or for those whom the doctor feels would benefit from long-term pain relief without the adverse effects of pain medication.

Would peripheral nerve stimulation be helpful for me?

Peripheral nerve stimulation is a flexible method of pain relief that may be used in a number of areas. These commonly include, but are not limited to:

  • Post-operative pain, including knee replacement

  • Acute or chronic neuropathy

  • Complex regional pain

  • Shoulder pain

  • Back pain

  • Chronic migraine and headache disorders

Some peripheral nerves which are commonly targeted with PNS include: suprascapular nerve for shoulder pain, extraarticular / genicular nerves for knee pain, cluneal nerves for low back pain, supraorbital, occipital, and supratrochlear nerves for headaches, intercostal nerves for chest wall pain, and ilioinguinal or iliohypogastric nerves for inguinal pain.

How would peripheral nerve stimulation benefit me?

According to a study published in 2018, doctors reported over 60% of their patients experienced a significant increase in their symptoms and lifestyle quality; over 45% of them reported an improvement in their ability to perform daily activities.

For patients who suffer the effects of chronic pain as indicated above, peripheral nerve stimulation can be an excellent way to ease pain, increase mobility, and reduce the use of analgesic medication.

What can I expect if I choose to try peripheral nerve stimulation?

During the procedure, the doctor threads the wire of electrodes into a needle through the skin that places it along the targeted nerve. The procedure is often accompanied with lighter anesthesia that prevents any discomfort you might otherwise experience.

The placement of the wire is guided by live X-ray imaging, allowing the doctor to target areas of the tissue specific to the location of your pain. The goal of the placement is to achieve a light tingling sensation, called paresthesia, that replaces the sensation of pain in the targeted area.

The entire process occurs in two stages. The first lasts about a week, and is nothing more than a trial period to determine if the stimulator is successful in masking the pain. During the week, an external battery patch is attached to the electrodes, and will generate the impulse that runs through the wire.

During this trial period, the patient has the flexibility to increase or decrease the sensation felt in the electrodes. A medical device representative is on call should you have any concerns during the week. They are also there to help you determine the optimal intensity of the nerve stimulation.

By the end of the week, patients that are satisfied with the results can proceed to the permanent implant. The wire is now permanently inserted underneath the skin, now able to provide pain relief as a permanent solution.

At Cahaba Pain and Spine Care, we are committed to reducing your pain and improving your overall quality of life. If you think you might be a candidate for peripheral nerve stimulation, we’d be pleased to schedule a consultation to discuss the treatment options together.