Wireless Peripheral Nerve Stimulation

If you have chronic pain, peripheral nerve stimulation can help. It uses electrical pulses to disrupt pain signals. It may reduce your need for pain medications. Here's how it works.

Am I a good candidate?

To determine if you’re a good candidate, the Interventional Pain Doctors team of spine and pain management specialists will meet with you, discuss treatment risks, benefits and alternatives. If you don’t want surgery or have tried and failed conservative measures, we may recommend peripheral nerve stimulation for you. This is a three-step process. First, we perform and image guided nerve block, placing local anesthetic (numbing medicine) around the nerve in question to see if your pain goes away. If your pain is eliminated temporarily, then you may be a good candidate for a trial of peripheral nerve stimulation where you get to try the therapy before getting the final procedure.  

• Trial: During a trial, a temporary lead (thin wire) is placed using a needle under the skin close to the affected nerve. This lead connects wirelessly to an external device that delivers stimulation to the the nerve to block pain signals. The trial lasts between 3 - 10 days, during which time you and your physician will assess the effectiveness of treatment. If you get significant relief of pain (50-100% reduction) and/or significant improvement in your function, and/or a 50% or greater reduction in narcotic pain medicine this is a successful trial. You are a good candidate for peripheral nerve stimulation, and temporary leads will be removed. If you do not get pain relief, the leads will be removed and permanent lead placement is not offered.
• Permanent: Permanent lead placement for peripheral nerve stimulation involves placing leads under the skin, close to the affected nerve. The power source is worn externally when stimulation is desired. There is no battery placed under the skin in peripheral nerve stimulation.  

What is the success rate?

We use the diagnostic nerve block and trial procedure to show who will get relief. It is the one area of medicine where you get to try the therapy and see if it is successful before having the permanent procedure.

Stimulation does not work for everyone and if you don’t get relief during the diagnostic nerve block a trial you will not be offered.

What are the complications?

A small percentage of patients may experience: hardware failure, loss of effectiveness, allergic reaction to the device, lead removal, and biological complications such as increased pain, and skin erosion. Sophisticated neuromodulation devices, doctor expertise, sterile operating conditions and image guidance keep complications to a minimum.

What to expect afterwards?

‍Your doctor and staff will explain what to expect before, during, and after the treatment. If you want sedation for your procedure, your doctor will advise you to avoid eating or drinking anything for eight hours before the procedure and to have a responsible adult drive you home. You are welcome to do the procedure awake, under local anesthesia if you would prefer. You may need to stop taking certain medicines (blood thinners) several days before your procedure.

All our injections are performed in the sterile operating room using image guidance. You will first be comfortably positioned and monitors to check your vital signs will be placed. Oxygen will be given to you if you get sedation. After a sterile cleaning of the site to be injected, sedation will be given if desired. Then local anesthesia will be used to numb the skin. The epidural needle will be placed using image guidance and confirmed with contrast dye. Medication will then be administered and needles removed. Bandages will be placed and you will be taken to the recovery room until you are ready for discharge home.

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