Chronic pain, especially chronic back pain, is one of the leading causes of disability in the U.S. For many, chronic pain can unfortunately lead to opioid use and misuse. However, there are other alternatives for chronic pain that may provide long-lasting pain relief without dangerous complications. One of these treatments is peripheral nerve stimulation. This is what you should know.
What is peripheral nerve stimulation?
Your peripheral nervous system includes 43 pairs of nerves that control sensation, movement, and motor coordination. If damaged, these nerves can cause excruciating, debilitating pain. Treating chronic neuropathic pain that occurs due to nerve damage in the face, neck, and head is exceptionally challenging.
Peripheral nerve stimulation is a treatment that can help. During the procedure, your doctor places electrodes along the course of damaged peripheral nerves to control pain. The electrodes produce a low voltage current that blocks the brain’s ability to sense the previously perceived pain. This electrical current replaces the perception of pain with a tingling sensation. The intensity of the stimulator can be changed, and the system can be turned on and off as needed. This provides the best level of pain relief for each patient.
For many patients who suffer from chronic peripheral nerve pain, this procedure offers pain relief when conservative pain measures did not help.
Peripheral nerve stimulation benefits
One of the main functions of peripheral nerves is to communicate signals from the organs, limbs, and skin to your brain. When your peripheral nerves become damaged, they do not function properly and can eventually produce symptoms of pain, tingling, or numbness.
This condition, called peripheral neuropathy, can be caused by many conditions including:
- Vitamin deficiencies
- Autoimmune diseases
- Certain medications
Pain from peripheral neuropathy does not often respond well to conventional treatment options. Many patients turn to opioid medications, but these are not recommended for the treatment of chronic pain.
Conditions that may benefit from peripheral nerve stimulation include:
- Complex regional pain syndrome
- Diabetic peripheral neuropathy
- Lateral femoral cutaneous neuropathy
- Back and neck pain
- Post-surgical pain
- Occipital neuralgia
- Trigeminal neuralgia
- Traumatic nerve injuries
- Peripheral vascular disease neuropathy
- Post-amputation pain
- Herpetic neuralgia
- Reflex sympathetic dystrophy (RSD)
- Refractory angina
- Other painful conditions that are not relieved with conventional therapies
Research continues to confirm the effectiveness of this treatment for many different conditions. Consider the following studies:
- Some reviews suggest that peripheral nerve stimulation can completely replace opioid pain medications even for post-surgical pain management
- Peripheral nerve stimulation relieves pain for the majority of post-amputation patients and reduces disability
- Just 60 days of peripheral nerve stimulation relieved chronic, refractory lower back pain for 12 months
Other than pain relief, one of the main benefits of peripheral nerve stimulation is the fact that it is low-risk and relatively side-effect free. Patients who have suffered for years may be able to find relief, safely and without medications.
How does the peripheral nerve stimulation procedure work?
The peripheral nerve stimulation procedure can be performed either with or without IV sedation, depending on your comfort level.
Using at least a local anesthetic, your doctor carefully places a thin stimulator lead along the painful nerves. This lead is connected to a battery that is barely visible underneath your skin. Like a pacemaker, the stimulator lies under the skin. It is a self-contained system. The stimulator is so small that you can wear bathing suits and continue normal activities without inconvenience.
Once turned on, the device releases electrical stimulation to the affected nerves. Instead of pain, you will feel a mild buzzing sensation. Patients typically undergo a trial for seven days to see if they feel better with the device. If pain improves, a permanent electrode and battery can be placed.
The entire procedure takes less than a couple of hours to complete and is done as an outpatient procedure.
Peripheral nerve stimulation risks
As with any surgical procedure, there are potential risks. Working with a doctor with extensive experience placing peripheral nerve stimulation devices can help you avoid some risks.
In general, side effects that may occur include:
- Scar tissue
- Electrode failure
- Inadequate pain surface area coverage
- Nerve damage
If you have a cardiac pacemaker, systemic infection, or are pregnant or breastfeeding, talk to your doctor about other pain relief options.
Peripheral nerve stimulation recovery
The entire peripheral nerve stimulation procedure takes one to two hours, depending on whether or not you receive sedation.
Bring a driver with you to drive you home after the procedure and take the day off. While the incision is healing it is important to keep it dry and clean so an infection does not occur. If you experience redness or swelling at the implantation site, use ice for comfort. Non-steroidal anti-inflammatory drugs (NSAIDs) can be used to help manage post-operative soreness.
If your test device is successful, a permanent device will be placed. After this procedure, your surgical site will take about two weeks to heal.
Look for any signs of infection at the site, including drainage, redness, or swelling that does not go away. Fever or a general feeling of being unwell is also a sign of infection. Talk to your doctor if you have concerns.
Chronic pain due to peripheral neuropathy can be life-changing and debilitating. But you don’t have to suffer. The team at Arizona Pain can develop an approach to treat and resolve refractory nerve pain that has not responded to other treatments.