Peripheral Nerve Stimulation (PNS)
Peripheral Nerve Stimulation (PNS) typically involves implanting a temporary wire in the body to help relieve chronic pain. The device, called a "Peripheral Nerve Stimulation" sends electrical impulses through wires/electrodes placed near a nerve in the part of the body in pain most commonly the back, shoulder, knee. The impulses block/alter pain signals reaching the brain. PNS does not cure chronic pain but may provided 50%-100% pain relief for up to one year after the lead is removed. The lead or electrodes are the size of a hair and are implanted under ultrasound guidance. No surgery is indicated for this procedure.
Candidates for Peripheral Nerve Stimulation
Not everyone is a candidate for Peripheral Nerve Stimulation. It is an option only for those who have tried, but been unsuccessful with, conservative treatments; will likely not be helped by surgery or are averse to surgery; are not addicted to drugs; and do not have pacemakers.
The Peripheral Nerve Stimulation Impant Process
Implantation of a peripheral nerve stimulator consists of using ultrasound and sometimes fluoroscopic guidance to place a small needle near a peripheral nerve in the region of pain. Next an external pulse generator sends elctrical signals to the nerve. Once the stimulation is consistently comfortable alleviating the pain the lead is deployed. A skin adhesive or glue is placed at the injection site and the area is covered with a sterile dressing. The device is powered by an external pulse generator that magnetically connects to the lead. The patient goes home same day with a remote control to adjust the therapy as needed.
Recovery from the Peripheral Nerve Stimulator Implantation Process
Pain from PNS implantation is minimal treated with over the over-the-counter painkillers. A patient should be cautious when lifting, bending, twisting and stretching during the healing process, which can take up to 1 week. Most patients experience significant procedural pain reduction the same day as the procedure.
Risks and Complications of Peripheral Nerve Stimulation
In addition to the risks associated with any interventional procedure, those related to PNS include nerve injury, hematoma, infection. Complications related specifically to the stimulator include the following:
- Device works only intermittently or stops
- Device causes over-stimulation or unpleasant sensations
- Stimulation occurs in the wrong place
- Device causes an allergic reaction
- Lead Migrates out of optimal position
It is also possible that the device's wires could shift or become damaged, which might require a relacement of the lead.
