Peripheral Nerve Stimulation
Peripheral nerve stimulation frequently referred to as PNS, is a commonly used approach to treat chronic pain related to both nociceptive and neuropathic pain. PNS involves a minimally invasive surgery that places a small electrical device (electrodes) next to one of the targeted peripheral nerves. The electrode delivers rapid electrical pulses that send afferent information to the thalamus that does not elicit a sensory response. Instead of a “sensation,” the signal creates a “traffic jam,” making it more difficult for painful stimuli to reach the sensory cortex. Additionally, neurochemical changes occur at the spinal cord and DRG level to help create an inhibitory response.
During the testing period (trial), the electrode is connected to an external device to provide the necessary energy. The patient trials the device typically 5-7 days. If the trial is successful, a small generator gets implanted into the patient’s body which is powered externally by an antenna and transmitter. Like heart pacemakers, electricity is delivered from the generator to the nerve or nerves using several electrodes on each lead. The patient can control stimulation by turning the device on and off and adjusting stimulation parameters.
This technology has helped fill a much-needed void for problems such as chronic pain after shoulder surgeries, total knee replacements, foot and ankle surgeries, and lumbar fusions.