Posted on May 21, 2023
Peripheral Nerve Stimulation (PNS) is revolutionizing pain management. PNS gives us the ability to treat many types of pain with direct stimulation of the specific nerves that are transmitting pain signals.
Ultimately for anything to hurt, the pain signal must be transmitted along nerves going first to the spinal cord and then the brain where it is interpreted.
In the past, we were only able to change the nerve conduction with spinal cord stimulation. This entailed surgical placement of “leads” (thin wires) in the spinal canal, which were attached to an implanted battery.
Now Peripheral Nerve Stimulation (PNS) makes it possible to alter the pain signal near the source of the pain so it is markedly diminished, leading to less pain.
Through PNS, it is finally possible to treat:
knee and shoulder arthritis pain
post surgical low back pain
post surgical knee pain, foot and ankle pain
as well as many other types of pain.
There are literally hundreds of nerves in the body that can be stimulated to control pain. Often, we begin by blocking the affected nerve at the bedside under ultrasound to determine the pain pathway.
Since arthritis pain is also transmitted by specific nerves, it is possible to treat certain types of arthritis pain for patients who are not surgical candidates with this method. This can work especially well for knee and shoulder arthritis pain.
Once we have identified the nerve pathway, we proceed with a week of trial simulation. In the procedure room using X-ray guidance, we place a thin wire through a needle next to the affected nerve. Once the device is tested and working properly, it is securely taped into place.
With an external battery stimulator in place, you are able to assess Peripheral Nerve Stimulation for up to one week. During that time, it may need to be reprogrammed to achieve pain relief. You will be evaluated one week later, at which time the wire lead is easily retracted.
If there is clearly more than 50% pain relief, it is reasonable to then proceed to the permanent stimulator implant. The implant is a minor, superficial procedure involving only two small incisions with minimal procedural discomfort.
With the PNS permanent stimulator, there is no battery power source that will ever need replacing. However, it is necessary to wear an external unit to transmit the energy to the stimulator wire receiver. Special wearables have been designed to accomplish this easily.
To learn more, or for an assessment for yourself or someone you know, call 239-437-8000 or visit: APMSS.net.