Peripheral Nerve Stimulation

What Is Peripheral Nerve Stimulation?

Peripheral nerve stimulation (PNS) is a neuromodulation technique where electrodes are placed near specific peripheral nerves to deliver mild electrical impulses. Unlike spinal cord stimulation which targets the spinal cord, PNS directly targets the nerves responsible for transmitting pain signals from a specific area.¹

How It Works²

Electrodes placed near target nerve
Mild electrical pulses delivered
Interrupts pain signal transmission
May work by gate control mechanism
Modulates nerve activity
Patient controls stimulation

Conditions Treated

Post-surgical neuropathic pain
Peripheral nerve injuries
Occipital neuralgia
CRPS (complex regional pain syndrome)
Post-amputation pain
Localized chronic pain
Some headache conditions

The Procedure³

Trial Period

Temporary electrode placement
Tests effectiveness for days to weeks
Determines if permanent helpful

Permanent Implant

Small electrode(s) placed near nerve
Generator implanted under skin
Outpatient or short stay procedure
Programming session after healing

Types of Systems

Traditional implanted systems
External powered systems
Ultrasound-guided temporary systems
Newer rechargeable devices
Technology advancing rapidly

Benefits

Targets specific pain area
Can be trialed first
Reversible (can be removed)
Adjustable settings
May reduce medication need

Risks and Considerations

Infection
Lead migration
Hardware malfunction
Skin irritation
May lose effectiveness
Not effective for everyone

Candidate Selection

Well-defined pain source
Failed conservative treatments
Positive response to nerve blocks
Psychological evaluation
Realistic expectations

Living with PNS

Regular device checks
Battery monitoring
Some activity restrictions
MRI compatibility varies
Carry device ID card

References

Deer TR, Mekhail N, Provenzano D, et al. The appropriate use of neurostimulation: avoidance and treatment of complications of neurostimulation therapies. Neuromodulation. 2014;17(6):571-598.
Slavin KV. Peripheral nerve stimulation for neuropathic pain. Neurotherapeutics. 2008;5(1):100-106.
Strand N, D'Souza RS, Hagedorn JM, et al. Evidence-based clinical guidelines from the American Society of Pain and Neuroscience for the use of implantable peripheral nerve stimulation. J Pain Res. 2022;15:2483-2504.