Percutaneous and Implanted Peripheral Nerve Stimulation for the Management of Pain: Current Evidence and Future Directions

Abstract

The goal of this review is to summarize the current state of percutaneous and implanted peripheral nerve stimulation for the relief of pain. This article provides an overview of commercially available devices, the evidence supporting their use, and novel treatments being considered for the future. There are four peripheral nerve stimulators commercially available in multiple countries around the world. The stimulation may be used temporarily, with percutaneous placement of leads, or indefinitely with permanent implantation of the leads. Two stimulation paradigms are described in the literature for treatment of pain—stimulation of motor (efferent) nerve fibers to create muscle contraction and stimulation of sensory (afferent) nerve fibers to create paresthesia. Peripheral nerve stimulation has been studied in musculoskeletal pain syndromes, neuropathic pain syndromes, craniofacial pain, and in acute post-operative pain. This pain-relieving treatment is a promising treatment though many applications have not yet been well studied.