Living with chronic pain can be a challenging and debilitating experience. It can affect our daily activities, diminish our quality of life, and limit our ability to fully engage with others.
Fortunately, medical advances have paved the way for innovative solutions. Roy M. Lerman, MD, a Physical Medicine and Rehabilitation doctor at Main Line Spine, says that “we now have numerous new options to alleviate chronic pain and improve overall well-being.”
“Among these is peripheral nerve stimulation, also known as PNS. This technique is proving to be effective in alleviating chronic pain. It can provide targeted, regional pain relief without the generalized effects or risk of dependence associated with opioid medications. That makes it a promising alternative,” Dr. Lerman says.
He describes this therapy as “a minimally invasive way of managing pain without medication.”
What Is Peripheral Nerve Stimulation?
Peripheral nerve stimulation is an outpatient procedure for chronic pain. It uses a small, neuromodulation medical device rather than prescriptive medicine for pain management. This technology uses mild electrical stimulation to mask pain signals before they reach the brain.
Dr. Lerman explains that “peripheral stimulation and neuromodulation use modern technology to manage old problems.”
During this procedure, your doctor places stimulating leads directly over the nerves in the peripheral region where the pain originates.
Several different configurations of peripheral nerve stimulation devices are available.
Depending on the specific device, a peripheral nerve stimulation system’s small stimulator is positioned outside the body or implanted. Usually, the peripheral nerve stimulator system locates its battery outside the body.
What Are Peripheral Nerves?
The nervous system of our body has two parts.
The central nervous system includes the brain and spinal cord.
The peripheral nervous system branches off the spinal cord and provides for the remainder of the body.
Peripheral nerves play a crucial role in transmitting sensory information, including touch, pain, and body temperature. They also transmit motor commands, such as muscle movement, between the central nervous system (the brain and spinal cord) and the organs, muscles, and skin.
What Can Peripheral Nerve Stimulation Be Used to Treat?
Dr. Lerman notes that, “Peripheral nerve stimulation can target specific areas, such as knees, shoulders, back, wrists, elbows, sacroiliac joints, feet, and ankles.”
He continues, “It can provide chronic pain relief for conditions such as chronic neuropathic pain, post-surgical pain, post-amputation pain (also known as phantom limb pain), low back pain, and neck pain. It can also relieve pain associated with specific conditions, including Complex Regional Pain Syndrome, diabetic neuropathy, and certain types of headaches and nerve pain.”
How Does a Peripheral Nerve Stimulator Work?
A patient’s doctor places very thin wires, called leads, targeted at specific peripheral nerves where the extremity pain is occurring. The neurostimulator, when activated, delivers small pulses of mild electric current through the leads to those peripheral nerves. These impulses mask pain signals traveling to the brain.
A patient can control their peripheral nerve stimulator with a remote. The remote can turn the peripheral nerve stimulator on or off and adjust the stimulation level up or down. It can also activate different custom programs to help them handle their pain.
A peripheral nerve stimulator does not eliminate the cause of a patient’s pain. However, it does alter the way the brain perceives pain.
What Are the Two Stages of the Peripheral Nerve Stimulator Implant Procedure?
There are two stages involved in the peripheral nerve stimulator procedure. Both procedures are performed as outpatient procedures.
The first is a trial stage, which is temporary. It helps confirm a patient’s experience of how well a peripheral nerve stimulator may relieve their pain during different activities.
Dr. Lerman notes that “the trial can be a window into what peripheral nerve stimulation is like before you finalize your decision to use it.”
The second is a surgical implant procedure. A decision to proceed will depend on the patient and their doctor’s assessment of the trial’s effectiveness.
Who Is a Good Candidate for a Peripheral Nerve Stimulator?
When talking about suitable candidates for peripheral nerve stimulation, Dr. Lerman said it was most appropriate for “those who have tried conservative treatments without adequate improvement.”
He recommended that “if you are suffering from chronic pain in a peripheral extremity, and want to avoid relief through medication, you should consider it as an option when consulting with your doctor.”