Overview & Procedure
Peripheral nerve stimulation (PNS) is a neuromodulation technique in which electrical current is applied to the peripheral nerves to improve chronic pain. It can be used to treat a number of painful conditions but is most often used to treat pain in the foot, knee, shoulder, or low back. Often the physician will perform a peripheral nerve block with local anesthetic to gain a better understanding if a patient is a candidate for PNS. This interventional pain management technique implants a permanent peripheral nerve stimulator under the skin that delivers regular electrical impulses to a specific peripheral nerve causing pain and blocks the messages before they can reach your brain. Before the device is implanted permanently, there is typically a trial period to determine if the therapy is effective for your chronic pain.
The Peripheral Nerve Stimulation trial/implant procedure is performed in an outpatient surgery center or hospital. PNS is performed in two steps. The first step consists of a test or trial. For this the patient’s physician will place a temporary PNS system near the area of their pain. This trial will typically last 5-7 days. If the patient’s pain is significantly improved during the trial, the patient will be scheduled for a permanent PNS implant. The implant will take place in an outpatient surgical center or hospital. Using fluoroscopy and/or ultrasound your doctor will place the PNS system in the same regions as the trial. The permanent implant will typically require two small incisions (less than a centimeter each). Once the device is placed, the patient will be transferred to the recovery room
Immediately after each procedure, patients are sent to a separate room to recover. During this time, the patient’s vitals are monitored for any signs of an adverse reaction.
For the trial avoid: heavy lifting, bending at the waist, or excessive twisting so as not to cause the leads to move internally. Tenderness at the procedure site or procedural discomfort is normal. As a patient proceeds through the trial, they will try to differentiate between typical pain and the procedural pain. The lead(s) will be positional, and the patient may experience different degrees of stimulation according to their positioning. The patient will keep their remote with them so that they may adjust the intensity as needed.
For the permanent implant, the patient will be sent to the recovery room after the procedure. Later that day, the patient will go home after they are given self-care instructions. An adult family member or friend will need to drive the patient home. Before leaving the clinic: patients are checked to be sure they have recovered from the anesthesia and are healthy enough to go home and given discharge instructions for self-care at home. A prescription for pain medication or other medications will be sent to the pharmacy following the procedure to be filled right away. Complications from this procedure are rare but may include fever, infection, bleeding, increased pain, or leg weakness. If the patient experiences these symptoms, they should report to the Southwest Spine and Pain Center. If it is after hours, they should report to the ER.