Peripheral Nerve Stimulation in the Treatment of Chronic Pain Syndromes From Nerve Injury: A Multicenter Observational Study

2016 ◽  
Vol 20 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Gianni Colini Baldeschi ◽  
Alessandro Dario ◽  
Giuliano De Carolis ◽  
Nicola Luxardo ◽  
Massimo Natale ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Observational Study ◽  
Peripheral Nerve ◽  
Nerve Injury ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Multicenter Observational Study ◽  
Pain Syndromes ◽  
Chronic Pain Syndromes

scholarly journals Mechanism of Peripheral Nerve Stimulation in Chronic Pain

Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_1) ◽  
pp. S6-S12 ◽  
Author(s):  
Tiffany Lin ◽  
Akshat Gargya ◽  
Harmandeep Singh ◽  
Eellan Sivanesan ◽  
Amitabh Gulati
Keyword(s):  
Chronic Pain ◽  
Literature Review ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Cochrane Library ◽  
Gate Control Theory ◽  
Comprehensive Literature Review ◽  
Gate Control ◽  
Chronic Pain Conditions

Abstract Introduction With the advancement of technology, peripheral nerve stimulation (PNS) has been increasingly used to treat various chronic pain conditions. Its origin is based on the gate control theory postulated by Wall and Melzack in 1965. However, the exact mechanism behind PNS’ analgesic effect is largely unknown. In this article, we performed a comprehensive literature review to overview the PNS mechanism of action. Design A comprehensive literature review on the mechanism of PNS in chronic pain. Methods Comprehensive review of the available literature on the mechanism of PNS in chronic pain. Data were derived from database searches of PubMed, Scopus, and the Cochrane Library and manual searches of bibliographies and known primary or review articles. Results Animal, human, and imaging studies have demonstrated the peripheral and central analgesic mechanisms of PNS by modulating the inflammatory pathways, the autonomic nervous system, the endogenous pain inhibition pathways, and involvement of the cortical and subcortical areas. Conclusions Peripheral nerve stimulation exhibits its neuromodulatory effect both peripherally and centrally. Further understanding of the mechanism of PNS can help guide stimulation approaches and parameters to optimize the use of PNS.

scholarly journals Peripheral Nerve Stimulation for Chronic Pain: A Systematic Review of Effectiveness and Safety

2021 ◽  
Author(s):  
Standiford Helm ◽  
Nikita Shirsat ◽  
Aaron Calodney ◽  
Alaa Abd-Elsayed ◽  
David Kloth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation

scholarly journals Percutaneous 60-day peripheral nerve stimulation implant provides sustained relief of chronic pain following amputation: 12-month follow-up of a randomized, double-blind, placebo-controlled trial

2019 ◽  
Vol 45 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Christopher A Gilmore ◽  
Brian M Ilfeld ◽  
Joshua M Rosenow ◽  
Sean Li ◽  
Mehul J Desai ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Short Form ◽  
Peripheral Nerve Stimulation ◽  
Pain Interference ◽  
Phantom Limb ◽  
Group 2 ◽  
Group 1

IntroductionPeripheral nerve stimulation (PNS) has historically been used to treat chronic pain, but generally requires implantation of a permanent system for sustained relief. A recent study found that a 60-day PNS treatment decreases post-amputation pain, and the current work investigates longer-term outcomes out to 12 months in the same cohort.MethodsAs previously reported, 28 traumatic lower extremity amputees with residual and/or phantom limb pain were randomized to receive 8 weeks of PNS (group 1) or 4 weeks of placebo followed by a crossover 4 weeks of PNS (group 2). Percutaneous leads were implanted under ultrasound guidance targeting the femoral and sciatic nerves. During follow-up, changes in average pain and pain interference were assessed using the Brief Pain Inventory–Short Form and comparing with baseline.ResultsSignificantly more participants in group 1 reported ≥50% reductions in average weekly pain at 12 months (67%, 6/9) compared with group 2 at the end of the placebo period (0%, 0/14, p=0.001). Similarly, 56% (5/9) of participants in group 1 reported ≥50% reductions in pain interference at 12 months, compared with 2/13 (15%, p=0.074) in group 2 at crossover. Reductions in depression were also statistically significantly greater at 12 months in group 1 compared with group 2 at crossover.ConclusionsThis work suggests that percutaneous PNS delivered over a 60-day period may provide significant carry-over effects including pain relief, potentially avoiding the need for a permanently implanted system while enabling improved function in patients with chronic pain.Trial registration numberNCT01996254.

Peripheral nerve stimulation in the treatment of intractable pain

1976 ◽  
Vol 45 (6) ◽  
pp. 692-699 ◽  
Author(s):  
James N. Campbell ◽  
Donlin M. Long
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Mechanisms Of Action ◽  
Peripheral Nerve Stimulation ◽  
Intractable Pain ◽  
Low Back ◽  
Content Type ◽  
Chronic Pain Conditions ◽  
Peripheral Nerve Trauma

✓ Peripheral nerve stimulating devices were implanted for pain control in 33 patients with a variety of disabling chronic pain conditions, which had persisted despite usual medical and surgical therapy. The implants were placed on major nerves innervating the area of the patient's pain. Records were obtained of each patient's stated relief from pain produced by nerve stimulation, along with assessments of narcotic withdrawal, ability to return to work, sleep pattern, and relief from depression. Based on these five criteria 17 patients were judged to be treatment failures, while eight patients had excellent results, and seven had intermediate results. Twelve of the failures were in patients with either low back pain with sciatica, or pain from metastatic disease. The most dramatic successes occurred in patients with peripheral nerve trauma. The incidence of complications has been low, and two patients have used the stimulator for 5 years without adverse effects. Techniques of peripheral stimulator implantation, possible mechanisms of action, and conclusions regarding peripheral nerve stimulation in the treatment of chronic pain are discussed.

scholarly journals Ultrasound-Guided Placement of a Permanent Percutaneous Femoral Nerve Stimulator Leads for the Treatment of Intractable Femoral Neuropathy

2009 ◽  
Vol 4;12 (4;7) ◽  
pp. E305-E308
Author(s):  
Samer N Narouze
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Cardiac Catheterization ◽  
Nerve Stimulation ◽  
Femoral Nerve ◽  
Peripheral Nerve Stimulation ◽  
Ultrasound Guided ◽  
Femoral Neuropathy ◽  
Femoral Nerve Injury ◽  
Good Coverage

Background: Femoral nerve injury is a rare complication of cardiac catheterization and is usually caused by direct trauma during femoral artery access, compression from a hematoma, or prolonged digital pressure for post-procedural hemostasis. Peripheral nerve stimulation has been used to treat different pain syndromes in the upper and lower extremities with variable success and it typically requires direct vision with open surgical approach. Since the femoral nerve can be readily seen with ultrasonography, an ultrasound-guided lead placement seemed practical. Case Report: A 61-year-old morbidly obese male who sustained femoral nerve injury during cardiac catheterization continued to complain of intractable femoral neuropathy 18 months afterwords. He failed multiple treatment modalities and continued to complain of severe neuropathic pains that markedly interfere with his daily activities. Two percutaneous leads were placed under real-time ultrasonography and the placement was confirmed with fluoroscopy. One lead was placed along the longitudinal axis of the nerve and the patient had good coverage over the anterior thigh but not below the knee. So another lead was placed horizontally across the femoral nerve in order to stimulate all the branches and the patient reported good coverage along the saphenous nerve distribution down to the foot. Results: The patient continues to be pain free 20 months after the implant. Conclusion: Here we described a novel non-invasive percutaneous approach for femoral nerve stimulation with ultrasound guidance which allowed precise placement of the stimulating lead very close to the femoral nerve without the need for surgical exploration. Key words: Femoral nerve stimulation, femoral neuropathy, ultrasound-guided lead implant, peripheral nerve stimulation

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