What is peripheral nerve stimulation?
Peripheral nerve stimulation (PNS) is a type of neuromodulation that is used to treat chronic (long-term) pain. It uses electrical stimulation to stop certain nerves sending pain signals to the brain.
Peripheral nerve stimulation specifically targets peripheral nerves, which are nerves that are located beyond the brain or spinal cord.
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What is it used to treat?
Peripheral nerve stimulation is used to treat chronic pain that is not responding well enough to physiotherapy, painkillers or other medications. It is effective in conditions where the pain is caused by a single nerve, but has also been shown to work well in treating many other pain syndromes.
Examples of conditions that may be treated by peripheral nerve stimulation include:
Chronic widespread pain
Also known as fibromyalgia, this is a complex and long-term condition characterised by pain throughout the body. It particularly affects the joints and muscles and is coupled with fatigue. Peripheral nerve stimulation can be used as a treatment in cases where other approaches have not helped.
Post herpetic neuralgia
This is a complication of shingles. It affects both the nerve fibres and the overlying skin causing a burning pain. The pain lasts long after the rash and blisters of shingles disappear. The treatment options for this condition remain limited but there is some ongoing studies assessing the use of peripheral nerve stimulation to treat this.
Neuropathic (nerve-related) conditions
These conditions cause long-term, difficult-to-treat pain due to nerve damage or trauma. They can also cause people to experience pain in response to movement or gentle touch (as in trigeminal neuralgia).
Chronic lower back pain
Peripheral nerve stimulation has shown benefits for treating chronic lower back pain that has been resistant to normal treatment with painkillers and targeted physiotherapy. It has been identified as an innovative treatment for back pain with significant results.
These include migraines, which often cause pain over one side of the head, nausea and light and sound sensitivity. They can be difficult to treat in some people, but peripheral nerve stimulation has been shown to help when other treatments have not been successful.
HOW DOES THE TREATMENT WORK?
The peripheral nerve stimulation system consists of a small electrical device that is connected to a tiny electrical wire called an electrode. The electrode is inserted near the target nerve using a small cut through the skin and muscle, and then secured in place using a tiny stitch.
Initially, the electrode is placed as a trial, with the electrical device being kept outside of the body. Peripheral nerve stimulation is then performed over a period of seven to ten days.
If the treatment successfully relieves pain, then a second procedure is performed to implant the electrical device more permanently under the skin.
Both procedures are done under either a local anaesthetic with light sedation or using a general anaesthetic. Following permanent implantation, there is a period of monitoring in hospital for one to two days and then a further review with a specialist after six to eight weeks.
What are the risks?
Peripheral nerve stimulation is considered to be a safe procedure, but as with any minor surgical procedures, there are a few risks to consider. These include:
- Infection at the insertion site
- Excessive bleeding or bruising around the insertion site
- Nerve damage
- Movement of the electrodes after implantation
- Mechanical failure of the system
- Failure to provide sufficient pain relief
- Allergic reaction to any of the medications used during the procedure.
Our specialists here at The London Clinic are very experienced in this procedure and will describe it in detail to patients considering it. They will be able to explain all of the risks and benefits of peripheral nerve stimulation, including those specific to each patient and will be happy to answer any questions.
How effective is it?
Recent studies show that between 60 - 70% of patients that have peripheral nerve stimulation procedures experience a 50% reduction in their long-term pain.
It is important to remember that this treatment is not the first option for managing pain, and is usually reserved for specialist cases that are not responding to normal methods of pain management.
Our experts and our experienced multidisciplinary team will be able to help advise each patient on the most appropriate treatment plan for them.
Why choose The London Clinic?
At The London Clinic, we believe in offering world leading, multidisciplinary care in pain management and neuromodulation. We invest in the latest technologies to ensure we remain at the cutting edge of innovation. From diagnosis through to treatment, we offer a wide range of services and rapid access to expert specialists in the field of neuromodulation.
What the experts say...
Peripheral nerve stimulation enables pains all over the body to be treated where other drugs and treatments have failed.