Peripheral Nerve Stimulation

  • Andrew G. Shetter
  • Gabor B. Racz
  • Royce Lewis
  • J. E. Heavner


The gate control theory of pain proposed by Mel-zack and Wall in 19651 suggested that electrical activation of large diameter afferent fibers would have an inhibitory effect on the central transmission of small diameter afferent fibers, thereby blocking pain perception. Wall and Sweet2 tested this hypothesis by observing that low threshold electrical stimulation of peripheral nerves via subcutaneous electrodes produced temporary pain relief in a group of five patients with posttraumatic neuralgias. This led Sweet3 in October 1965 to perform the first permanent implantation of a peripheral nerve electrode in an attempt to obtain long-term pain relief. Peripheral nerve stimulation (PNS) has been employed by numerous other investigators since that time, and it has become established as a valid treatment option in a small group of carefully selected patients.


Pain Relief Peripheral Nerve Nerve Block Reflex Sympathetic Dystrophy Peripheral Nerve Stimulation 
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  1. 1.
    Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:971–978.PubMedCrossRefGoogle Scholar
  2. 2.
    Wall PD, Sweet WH. Temporary abolition of pain in man. Science. 1967;155:108–109.PubMedCrossRefGoogle Scholar
  3. 3.
    Sweet WH. Control of pain by direct electrical stimulation of peripheral nerves. Clin Neurosurg. 1976;23:103–111.PubMedGoogle Scholar
  4. 4.
    Chung JM, Fang ZR, Hori Y, Lee KH, Willis WD. Prolonged inhibitor of primate spinothalamic tract cells by peripheral nerve stimulation. Pain. 1984;19:259–275.PubMedCrossRefGoogle Scholar
  5. 5.
    Chung JM, Lee KH, Hori Y, Endo K, Willis WD. Factors influencing peripheral nerve stimulation produced inhibition of primate spinothalamic tract cells. Pain. 1984;19:277–293.PubMedCrossRefGoogle Scholar
  6. 6.
    Ignelzi RJ, Nyquist JK. Excitability changes in peripheral nerve fibers after repetitive electrical stimulation. Implications in pain modulation. J Neurosurg. 1979;51:824–833.PubMedCrossRefGoogle Scholar
  7. 7.
    Campbell JN, Taub A. Local analgesia from percutaneous electrical stimulation. A peripheral mechanism. Arch Neurol. 1973;28:347–350.PubMedCrossRefGoogle Scholar
  8. 8.
    Wall PD, Gutnick M. Ongoing activity in peripheral nerves: the physiology and pharmacology of impulses originating from a neuroma. Exp Neurol. 1974;43:580–593.PubMedCrossRefGoogle Scholar
  9. 9.
    Racz, GB, Lewis R Jr, Heavner JE, Scott J. Peripheral nerve stimulator implant for treatment of causalgia. In: Pain and the Sympathetic Nervous System. Stanton-Hicks M, ed. Boston: Kluwer Academic Publishers; 1990:225–239.Google Scholar
  10. 10.
    Picaza JA, Hunter SE, Cannon BW. Pain suppression by peripheral nerve stimulation. Appl Neurophysiol. 1977/1978; 40:223–234.PubMedGoogle Scholar
  11. 11.
    Campbell JN, Long DM. Peripheral nerve stimulation in the treatment of intractable pain. J Neurosurg. 1976;45:692–699.PubMedCrossRefGoogle Scholar
  12. 12.
    Long DM, Erickson DL, Campbell JN, North RB. Electrical stimulation of the spinal cord and peripheral nerves for pain control. A 10-year experience. Appl Neurophysiol. 1981;44:207–217.PubMedGoogle Scholar
  13. 13.
    Law JD, Swet J, Kirsch WM. Retrospective analysis of 22 patients with chronic pain treated by peripheral nerve stimulation. J Neurosurg. 1980;52:482–485.PubMedCrossRefGoogle Scholar
  14. 14.
    Nashold BS, Goldner JL, Mullen JB, Bright DS. Long-term pain control by direct peripheral nerve stimulation. J Bone Joint Surg. 1982;64A:1–10.Google Scholar
  15. 15.
    Racz GB, Holubec JT. Stellate ganglion phenol neurolysis. In: Techniques of Neurolysis. Racz GB, ed. Boston: Kluwer Academic Publishers; 1989: 133–144.Google Scholar
  16. 16.
    Cooney WP. Chronic pain treatment with direct electrical nerve stimulation. In: Gelberean RH, ed.. Operative Nerve Repair and Reconstruction. Philadelphia, Pa: JB Lippincott; 1991:1551–1561.Google Scholar
  17. 17.
    Hassenbusch SJ, Stanton-Hicks M, Walsh J, Covington EC, Oswalt K. Effects of chronic peripheral nerve stimulation in stage HI reflex sympathetic dystrophy (RSD).Google Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Andrew G. Shetter
  • Gabor B. Racz
  • Royce Lewis
  • J. E. Heavner

There are no affiliations available

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