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Peripheral Nerve Stimulation: Targeted Pain Relief for a Better Life

Canopy of barren trees seen from ground level.

Chronic pain can be a relentless burden, affecting every aspect of your life. If you've tried traditional treatments without success, you may be searching for alternative solutions. At Pain Specialists of America, we offer innovative therapies like peripheral nerve stimulation (PNS) to help you find lasting relief.

To understand how PNS works and its potential benefits, we need to first understand the nervous system.


The Peripheral Nervous System: Your Body's Communication Network

Dr. Jerry Gutierrez explains the nervous system in a way that's easy to understand: "It's divided into central and peripheral.Central refers to the brain and spinal cord... The peripheral nervous system is all the little nerve branches that are an extension of the central nervous system."

Think of it like a tree, he says. "They typically start with nerve roots that turn into branches, that turn into peripheral nerves, that turn into other peripheral nerves. So it's like a tree trunk that has several branches and then little twigs..."

This intricate network of nerves extends throughout your body, carrying signals that control movement, sensation, and organ function. 

When these peripheral nerves are damaged or diseased, they can send faulty pain signals, leading to chronic pain. PNS therapy offers a targeted approach to addressing these issues, focusing on the specific "twig" or "branch" that's causing the problem.

What is a Peripheral Nerve Stimulator?

A peripheral nerve stimulator is a small, minimally invasive device that is implanted near a specific peripheral nerve. These nerves extend outside of your brain and spinal cord, carrying signals to and from your limbs and organs. When these nerves are damaged or diseased, they can send faulty pain signals, leading to chronic pain.

PNS works by delivering mild electrical impulses to the affected nerve, effectively blocking these pain signals from reaching your brain. Think of it like a "mute" button for your pain. Dr. Gutierrez, a pain management specialist at PSA, explains that PNS devices can operate in two modes: one that produces a tingling sensation and another that alleviates pain without any sensation at all.


What Conditions Can PNS Treat?

PNS is highly effective in treating various types of chronic pain, particularly those associated with nerve damage. Some conditions that can benefit from PNS include:

  • Mononeuropathy in the extremities
  • Post-operative pain (e.g., knee replacements, ankle surgeries)
  • Arthritis affecting a single joint
  • Chronic pain localized to one or two specific nerves

PNS can be particularly helpful for peripheral nerve stimulator implant knee pain after surgery or due to nerve damage. It's a less invasive option for patients who may not be ideal candidates for surgery or those who want to avoid the risks of general anesthesia.


The PNS Procedure

Before receiving a permanent PNS implant, you'll undergo a trial period with a temporary device. This allows you to experience the therapy and assess its effectiveness for your pain.

The implantation procedure itself is minimally invasive, typically performed as an outpatient procedure. Recovery time is generally short, with most patients able to return to their daily activities within a few days.

How Long Do Peripheral Nerve Stimulators Last?

The longevity of a peripheral nerve stimulator (PNS) depends on several factors, including the type of device, the settings used, and the individual's pain condition.

In some cases, PNS is used as a short-term treatment to "reset" or correct nerve activity and provide long-lasting relief. Dr. Gutierrez explains that "sometimes we can change the course of nerve pain by stimulating it for 60 days, and it might go back to normal and not return." He's observed patients experiencing pain relief for up to two years, or even permanently, after just a 60-day treatment with a temporary PNS system.

For those with more chronic pain, a permanent PNS implant may be recommended. These implants typically have a battery life of several years, depending on the device and usage. When the battery eventually runs low, a minor procedure is required to replace it, similar to replacing a pacemaker battery.

Interestingly, Dr. Gutierrez notes that PNS often provides a "lingering effect," where patients continue to experience pain relief even after the stimulation is turned off. This extended relief is attributed to the way PNS can "alter the behavior of a nerve." This means that with PNS, you may not need to have the stimulator on constantly to experience pain relief, which can prolong the battery life of your device.

Ultimately, the lifespan of a PNS system is influenced by individual factors and the specific device used. Your doctor can provide more personalized information about what to expect based on your condition and treatment plan.


PNS vs. TENS: What's the Difference?

While both PNS and transcutaneous electrical nerve stimulation (TENS) use electrical stimulation, they differ in key ways. TENS units are external devices with electrodes placed on the skin, providing temporary pain relief. This pain relief is also more specific to the musculoskeletal system.

PNS, on the other hand, involves a more targeted and long-term approach, targeting the specific nerve causing pain. The stimulator can be either external or implanted under the skin, with leads placed close to the affected nerve. This allows for far more precise and continuous stimulation.

PNS vs. SCS: What’s Right for Me?

While both PNS and spinal cord stimulation (SCS) use electrical impulses to relieve pain, they target different areas of the nervous system. Dr. Gutierrez explains the difference using a helpful analogy: "Think of the nervous system like a tree. SCS is like treating the trunk, while PNS is like treating a specific branch or twig." 

"A peripheral nerve stimulator would be good for somebody that has maybe just a certain twig or small branch that's injured," says Dr. Gutierrez. "You can really get a PNS in intimate proximity to that one nerve that we've identified as being the culprit... and just get that one focal area."

This means that PNS is ideal for treating pain that originates from a specific nerve, while SCS is more effective for widespread pain.


Benefits of PNS

PNS offers several advantages over traditional pain management methods:

  • Targeted pain relief: PNS delivers stimulation directly to the source of your pain, providing more focused and effective relief.
  • Minimally invasive: The procedure for implanting a PNS device is less invasive than surgery, resulting in less discomfort and a faster recovery time.
  • Customizable therapy: You can control the device and adjust the settings to meet your individual needs.
  • Potential for long-term relief: PNS can provide significant and lasting pain reduction for many patients.

Improved quality of life: By reducing pain, PNS can help you regain your mobility, participate in activities you enjoy, and improve your overall quality of life.

Addressing Concerns and Disadvantages

While PNS is generally safe and effective, it's essential to be aware of potential considerations:

  • MRI compatibility: Some PNS devices may have restrictions regarding MRI scans.
  • Potential risks: As with any surgical procedure, there's a small risk of infection or skin irritation at the implant site.
  • Lead migration: In rare cases, the leads of the device may shift from their original position.

Your doctor will discuss these factors with you in detail and address any concerns you may have.


PSA's Expertise in PNS

At PSA, we're committed to providing comprehensive and patient-centered PNS therapy. Our experienced pain specialists, like Dr. Gutierrez, will guide you through the process, from the initial consultation to the trial period and, if appropriate, the permanent implant. We're dedicated to helping you achieve the best possible outcome with PNS.

If you're struggling with chronic pain and want to explore whether PNS is right for you, contact PSA today to schedule a consultation. We're here to answer your questions, address your concerns, and help you find lasting relief.