Peripheral Nerve Stimulation

What is Peripheral Nerve Stimulation?

Peripheral nerve stimulation (PNS) is a minimally invasive treatment for chronic pain and pain caused due to peripheral nerve damage. The peripheral nerves connect your brain and spinal cord with the rest of the body. Pain arises from the signals produced by a nerve when it is stimulated by tissue damage or when the nerve itself is damaged (neuropathic pain). Peripheral nerve stimulation involves stimulation of the affected nerves using electrical impulses generated by a device implanted in your body. This interrupts the transmission of pain signals so that, instead of pain, you experience a mild tingling.

Peripheral nerve stimulation may be used as part of a comprehensive musculoskeletal care plan for conditions involving the joints, spine, or extremities, especially when pain has not improved with conservative treatment.

Common Conditions Treated

• Chronic knee pain after injury or surgery
• Shoulder pain
• Hip pain
• Back or neck pain
• Foot and ankle pain
• Nerve-related pain in the arms or legs
• Post-surgical pain syndromes
• Complex regional pain syndrome (in select cases)

Benefits of Peripheral Nerve Stimulation

• Minimally invasive outpatient procedure
• No major surgery required
• Drug-free pain relief option
• Can reduce reliance on pain medications
• Adjustable and reversible treatment
• May improve mobility and daily function

Preparation for Peripheral Nerve Stimulation

The process often begins with an evaluation to determine if the pain source is nerve-related. Some patients may undergo a temporary trial first. If successful, a longer-term device may be recommended.

Procedure for Peripheral Nerve Stimulation

The procedure for peripheral nerve stimulation is performed in 2 steps that include:

Step 1

• This is a trial procedure that begins with the insertion of electrodes.
• You will be instructed to lie on the observation table and anesthesia will be injected to make the site of insertion numb.
• A small incision will be made and the target nerves will be located.
• Through the incision, the electrodes are inserted and fixed along the targeted nerves
• The electrode wires are connected to an external stimulator which you can control to produce the impulses.
• Following insertion of the electrodes, you will be kept under observation in the recovery room and can return home the same day.
• The trial lasts for about a week and if you have significant pain relief and are happy with the results, the second step is performed. The trial also helps your doctor determine the right amount of stimulation for ideal pain relief 

Step 2

• This step will be performed a few days or weeks after a successful trial.
• During this procedure, anesthesia will be administered and the temporary external wires will be removed.
• Wires running under the skin are attached from the electrodes to a battery-operated internal stimulator implanted under your skin and programmed to deliver the determined level of stimulation. The internal stimulator is usually placed in the upper buttock, chest wall, or under the arm.

Post-operative Care and Recovery for Peripheral Nerve Stimulation

After the peripheral nerve stimulation procedure, you will be kept under observation for a few hours and can then go back home. On discharge, you will receive aftercare instructions and will be informed about certain restrictions such as avoiding metal detectors at airports. Your incision site should be kept dry and should heal within two weeks at which time you will have a follow-up appointment. Avoid strenuous activity for at least 6 weeks. 

Risks and Complications of Peripheral Nerve Stimulation

As with any procedure, there may be certain risks and complications associated with peripheral nerve stimulation which include:

• Nerve damage
• Pain
• Scar tissue formation
• Infection
• Bleeding
• Muscle cramps
• Malfunctioning of the stimulator or damage to the leads

Modern Peripheral Nerve Stimulation (PNS) has evolved significantly, offering smaller devices, less invasive procedures, and more personalized pain relief options. Today’s techniques focus on precisely targeting painful nerves while minimizing recovery time and reducing the need for medication.