When dealing with chronic pain, finding treatment options can be a long-term process that requires back-to-back appointments or trial-and-error medications. Peripheral nerve stimulation may be an option for you. This procedure helps patients manage chronic pain caused by various conditions.
Because every patient is different, it’s important to thoroughly understand this treatment and how it can help manage or treat your chronic pain condition. In the pursuit of pain relief, we hope to provide some insight into the potential benefits that peripheral nerve stimulation may provide.
Peripheral nerve stimulation, also called PNS, is a common procedure used to treat chronic and acute pain. The term “peripheral” refers to the nerves that are located outside the brain and spinal cord. PNS involves placing electrodes along the damaged peripheral nerves to stimulate electricity in the body. Patients receive a small electrical device implant that delivers mild electrical currents or pulses to essentially “turn off” the pain signals from the brain, resulting in pain relief.
Stimulating the peripheral nerves with gentle, rapid pulses can flood the nerve with this sensation, preventing it from signaling other sensations like pain. Our brains signal pain to alert us of dangerous situations or prevent us from participating in potentially harmful activities. However, chronic pain is much different. Those who struggle with chronic pain experience significant discomfort that may not actually be helpful. Using peripheral nerve stimulation, these constant pain signals are replaced with a neutral tingling sensation.
After a consultation, patients who decide to undergo peripheral nerve stimulation will experience a trial period. At first, the patient’s electrode will be connected to an external device to determine if they have a positive response to the temporary electrodes. If so, the patient will receive a permanent electrode implanted at the nerve site, accompanied by an internal battery-operated stimulator, similar to a pacemaker battery.
Once the electrodes are in place, the patient can control the level of stimulation to make it stronger or weaker as needed.
There are several FDA-approved peripheral nerve stimulators that may be suitable for your chronic pain needs, including:
All peripheral nerve stimulation devices work similarly and have the same major components — a pulse generator, or neurostimulator, a battery and lead electrodes. These devices may differ by whether they are placed inside or outside of the body and if they connect wirelessly or directly to stimulating leads.
Peripheral nerve stimulators may be confused with spinal cord stimulators (SCS). As the name suggests, a spinal cord stimulator generally performs the same stimulating functions, except it is placed near the spinal cord where the damaged nerve generates. A spinal cord stimulator will be positioned in the epidural spot. Spinal cord stimulation may be more suitable if the pain originates in a patient’s spine, while peripheral nerve stimulation targets other origins. Both types of stimulators are intended for chronic pain relief.
Results will vary when using peripheral nerve stimulation therapy. Some patients respond well to the trial but have less success with the permanent implant, while the opposite may be true for others.
The ultimate goal of this procedure is to provide substantial pain relief, but it may take several days to determine the exact location of the pain and whether the device works well for you. Fortunately, the peripheral nerve stimulator procedure is relatively simple and quick. The electrical device is placed just under the skin through a minimally invasive incision.
As for the stimulation itself, some patients can expect to feel a light tingling sensation, known as paresthesia. This replaces the chronic pain you are used to with a “pins and needles” feeling. Your physician will help you learn how to adjust your stimulator so you can more easily manage your pain relief. Generally, most patients can resume normal activities after recovery.
Peripheral nerve stimulators offer a range of benefits for those seeking relief from chronic pain and conditions.
Are you in the process of researching treatment options for your chronic pain? Has your doctor mentioned peripheral nerve stimulation to you? Being informed about the peripheral nerve stimulation procedure can help you decide whether it’s right for you. Here are some common questions patients might have about the process.
Patients who have isolated, chronic pain can be a good candidate for peripheral nerve stimulation. This means the pain has an identifiable nerve target and does not radiate out to other locations in the body. A peripheral nerve stimulator may be suitable for you if you suffer from the following conditions:
Patients who wish to avoid or discontinue medication to treat their chronic pain may benefit from this procedure. You may also be a good candidate for peripheral nerve stimulation if you have tried several treatment options with poor results.
For example, patients who have tried medication with no improvement or have severe side effects might pursue peripheral nerve stimulation. Keep in mind that this procedure is not suitable for all types of chronic pain and is not generally encouraged as an initial treatment option.
As with any procedure or surgery, there is always risk involved. Peripheral nerve stimulators generally have a high success rate of efficacy and longevity, but there is a small chance that you might experience complications.
Here are the potential side effects and risks of peripheral nerve stimulation:
In some cases, patients may find that their electrode device causes:
Be sure to discuss any risks or concerns with your doctor before undergoing this procedure. Your provider will communicate more specific outcomes based on your overall health and condition.
A peripheral nerve stimulator can target many different nerves in the body to alleviate pain. The sciatic nerve is commonly targeted during this procedure, as it is the largest nerve in the body. This nerve is responsible for transmitting motor and sensory signals throughout the lower extremities. Ultimately, the targeted nerve will be determined by your provider after they assess your condition to identify the source of pain.
The answer is as often as you wish. Some patients may only require it every other day or once a day, while others may need it 24 hours per day. The frequency, duration and intensity entirely depend on your needs and comfort level. Although the stimulator may not eliminate all of the pain, it should reduce it significantly if you respond well to it in the trial.
Be sure to disclose any medical conditions or medications you take with your provider prior to your peripheral nerve stimulator implantation. Let your doctor know if you meet any of the following criteria:
If you are pregnant, you must postpone the procedure to a later date, as it is not safe during pregnancy. However, not all of the above conditions will disqualify you from being a good candidate for a peripheral nerve stimulator. Your doctor may simply need to make adjustments based on your medical needs.
For example, those on blood thinners may need to stop their medication for a short time before the procedure. Those with diabetes will need to control their blood sugar before and after the procedure. Take all medications as prescribed prior to the procedure unless otherwise instructed by your doctor.
Be sure to disclose any medical conditions or medications you take with your provider prior to your peripheral nerve stimulator implantation. Let your doctor know if you meet any of the following criteria:
If you are pregnant, you must postpone the procedure to a later date, as it is not safe during pregnancy. However, not all of the above conditions will disqualify you from being a good candidate for a peripheral nerve stimulator. Your doctor may simply need to make adjustments based on your medical needs.
For example, those on blood thinners may need to stop their medication for a short time before the procedure. Those with diabetes will need to control their blood sugar before and after the procedure. Take all medications as prescribed prior to the procedure unless otherwise instructed by your doctor.
Peripheral nerve stimulation can reduce your chronic pain and enable you to gain back your mobility and strength. This minimally invasive surgery can treat a variety of conditions and give you direct control over your pain management without medication.
At New York Spine Institute, it’s our goal to restore your quality of life. If your chronic pain is holding you back from doing what you love, we can help you find relief. Our experienced team of pain management specialists, physiatrists, neurosurgeons and orthopedic spine surgeons are committed to providing personalized services that meet your unique pain needs.
If you’re considering a peripheral nerve stimulator and want to learn more, contact our team today to see if it’s right for you.
