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Peripheral Nerve Stimulation

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Essentials of Interventional Techniques in Managing Chronic Pain

Abstract

Peripheral nerve stimulation (PNS) has become a plausible alternative for the treatment of chronic pain caused by neuropathies in which conservative treatments have failed to produce relief. Even though a complete mechanism of action has not been elucidated, a body of continuously growing clinical evidence supports its utilization in various morbidities including neuralgias; chronic migraine and headaches; chronic pain in the limbs, back, pelvis, and abdomen; and pain syndromes such as CRPS and interstitial cystitis. Stimulation is done mainly by using an implantable programmable generator of electrical pulses delivered to the affected nerve(s) using an array of electrodes. Two surgical approaches are common. One involves the positioning of the stimulating array in the proximity of the affected peripheral nerve, while the other involves percutaneous positioning, without the need to be too proximal to the affected nerve. A trialing period is required to assess proper level of pain relief and improvement in the quality of life of the patient. Technological advances (miniaturization, battery performance, lead design) will make PNS an attractive treatment option for painful conditions, but there is still a need for prospective RCTs to provide substantial evidence of the potential benefits of the treatment.

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Acknowledgments

This book chapter is modified and updated from a previous book chapter, “Peripheral Nerve Stimulation” by Ramsin Benyamin, MD, in Interventional Techniques in Chronic Non-Spinal Pain published by ASIPP Publishing. The permission has been obtained from ASIPP Publishing.

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Authors and Affiliations

  1. Millennium Pain Center, Bloomington, IL, USA

    Ramsin Benyamin, Ricardo Vallejo & David L. Cedeño

  2. University of Illinois, Champaign-Urbana, IL, USA

    Ramsin Benyamin

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  1. Ramsin Benyamin
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  2. Ricardo Vallejo
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  3. David L. Cedeño
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Correspondence to Ramsin Benyamin .

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Editors and Affiliations

  1. Pain Management Center of Paducah, Paducah, Kentucky

    Laxmaiah Manchikanti

  2. Department of Anesthesia, LSU Health Science Center, New Orleans, Louisiana, USA

    Alan D. Kaye

  3. Mid Atlantic Spine and Pain Physicians, Newark, Delaware

    Frank J.E. Falco

  4. Service Line Chief of Interventional Radiology, Director of Interventional Neuroradiology, Chief of NeuroInterventional Spine Service, Massachusetts General Hospital, Boston, Massachusetts, USA

    Joshua A. Hirsch

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Benyamin, R., Vallejo, R., Cedeño, D.L. (2018). Peripheral Nerve Stimulation. In: Manchikanti, L., Kaye, A., Falco, F., Hirsch, J. (eds) Essentials of Interventional Techniques in Managing Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-60361-2_46

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