Over the past several years, there has been a tremendous amount of excitement over the use of peripheral nerve stimulation for neuropathic pain. In the past, peripheral nerve stimulator were placed surgically over the nerve of choice, but with the advent of ultrasound and small electrodes, it can be done under local anesthesia in an office or ambulatory surgical care center (ASC). Peripheral nerve stimulation can have several benefits over spinal cord stimulation in certain situations, especially that it can target a particular damaged nerve, and does not have to be placed in the central nervous system. Oftentimes, an in-office local anesthetic block can be used to help determine whether or not there is evidence of peripheral nerve injury. Additionally, there are some peripheral nerve stimulator devices that are not permanent, can be applied for only 60 days, and do not have to have a battery implanted into the skin! While it may not seem intuitive, the temporary peripheral nerve stimulators have been shown to have long-term benefits even after removal.
Peripheral nerve stimulation can be effective when there is evidence of complex regional pain syndrome, and damage to nerves as a result of trauma or surgery. This includes things such as post-inguinal hernia pain over the groin, burning knee pain or foot pain after surgery, and even low back pain! There is also growing evidence of the benefits of peripheral nerve stimulation for shoulder pain in those who are not good candidates for surgery. Additionally, peripheral nerve stimulation can be a good bridge between conservative management and a permanent implant.
As always, patient selection is critical to good outcomes. We are always happy to discuss whether peripheral nerve stimulation would be an optimal choice for you!
Here are a couple links to popular peripheral nerve stimulator options!