Peripheral Nerve Stimulation

Peripheral nerve stimulation, frequently referred to as PNS, is a commonly used approach to treat chronic pain. It involves surgery that places a small electrical device (a wire-like electrode) next to one of the peripheral nerves. (These are the nerves that are located beyond the brain or spinal cord). The electrode delivers rapid electrical pulses that are felt like mild tingles (so-called paresthesias). During the testing period (trial), the electrode is connected to an external device, and if the trial is successful, a small generator gets implanted into the patient’s body. Similar to heart pacemakers, electricity is delivered from the generator to the nerve or nerves using one or several electrodes. The patient is able to control stimulation by turning the device on and off and adjusting stimulation parameters as needed.

PNS was invented in the mid-1960s, even before the commonly used spinal cord stimulation. Starting in 2012, a number of therapeutic devices that stimulate peripheral nerves or that provide peripheral nerve field stimulation received regulatory approval in a number of regions around the world for treatment of neuropathic pain and, in some geographic areas, for treatment of migraine headaches and overactive bladder.

Some peripheral neurostimulation devices share technical similarities with methods developed and used for vagus nerve stimulation (widely used for treatment of epilepsy and depression), phrenic nerve stimulation (used for respiratory insufficiency due to impairment of diaphragmic control), and sacral nerve stimulation (approved for treatment of urinary incontinence and used for variety of bladder conditions).

Reviewed July 6, 2019
Konstantin Slavin, MD
Secretary, International Neuromodulation Society, 2017-2021
Professor, Department of Neurosurgery, University of Illinois at Chicago, Chicago, Ill., USA

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