Peripheral nerve stimulation is a pain management technique that uses electrical impulses to disrupt pain signals as they travel through the nerves, relieving individuals that suffer from chronic pain.
Should you’ve ever been hit within the funny bone, you possibly can conclude that pain travels like a “jolt” through the body. Specifically, every sensation, feeling, and thought results from an electrical impulse, or series of impulses.
Our nervous system comprises billions of neurons, each resting or energetic. Consider it like 1s and 0s – that is how our body communicates voluntary and involuntary actions and sensations. Minerals called electrolytes like sodium and potassium are crucial for this task. It’s considered one of several reasons we want to replenish our minerals and fluids after we sweat lots, or we’d cramp.
This data provides the muse for a lot of electrical therapies targeting muscle tissue and neurons. Physical therapists sometimes use electrical stimulation to assist muscles on the road to physical recovery after an injury. Doctors also use peripheral nerve stimulation to evaluate a nerve’s function and neuromuscular transmission in paralyzed patients – i.e., to find out the degree to which a patient’s nerve function is impaired.
Similarly, pain specialists may utilize nerve stimulation to handle malfunctioning nerves (neuropathy) or stop the pain. That’s how peripheral nerve stimulation was first invented.
What’s Peripheral Nerve Stimulation?
Utilizing an electrical pulse to activate or deactivate a nerve at the appropriate time could reduce or interrupt the transmission of pain signals. Within the Nineteen Nineties, this theory resulted in the event and use of specialised nerve stimulation devices to assist address severe chronic pain. Peripheral nerve stimulation devices are called such because they typically goal the peripheral nerves – i.e., your motor nerves, sensory nerves, and nerve roots.
Nevertheless, there have been a number of drawbacks to those devices. They utilized a sizeable electric lead, which needed to be implanted within the body, and led to the goal nerve. In addition they involved cumbersome devices that may charge the lead and were thus each invasive and intrusive. Electrical stimulation for nerve pain became relegated to a type of per-session outpatient treatment or an outlier alternative to opioid and non-opioid pharmacology.
Until recently, the opioid epidemic has spurred medical technology and pharmaceutical corporations to search out alternative opioid medication for long-term pain management. While treating acute pain with opioids is one thing, chronic pain patients face a much greater risk of long-term uncomfortable side effects from opioid use. Moreover, studies have shown that opioids change into less useful for chronic pain the more prolonged the pain occurs, meaning higher alternatives have all the time been needed. Medication management strategies have emerged as an efficient approach to minimize the risks related to long-term opioid use.
Breakthroughs in nerve stimulation technology allow for the usage of leads which are no thicker than human hair and completely unintrusive, in addition to much smaller, far less intrusive stimulator devices and modern wireless activation reasonably than a continuous pulse.
Peripheral nerve stimulation is now available as a viable non-opioid alternative for chronic and acute pain in conditions akin to neuropathic back pain, post-surgery shoulder pain, knee injuries, or diabetes-based foot pain.
How Does Peripheral Nerve Stimulation Impact Chronic Pain?
Newer peripheral nerve stimulation devices are a modality like many others, albeit more recently. But that shouldn’t be discouraging. Modern peripheral nerve stimulation devices have been thoroughly tested and vetted and have undergone rigorous testing with the FDA to receive official federal approval. Moreover, the idea for this technology is a long time old, and far of the older research still applies. These devices are smaller, safer, and more convenient now.
But as with every pain management tool, applicability just isn’t universal. Not all chronic pain victims will profit from using peripheral nerve stimulation devices.
Nevertheless, their efficacy is high: about 75 percent of chronic pain applicants benefitted from the implants, and over 50 percent reported long-lasting relief. Moreover, opposed reactions – akin to lead infections, continuous bleeding, or other serious issues – were infrequent.
As for a way and why it really works: a straightforward explanation requires us to return to the undeniable fact that nerves exist to move electrical signals throughout the body. All types of electricity are positively or negatively charged. Stimulating a nerve directly allows us to activate it or cancel its activation. Targeted nerve pulses may end up in direct pain reduction for acute and chronic pain, depending on the character and reason behind a patient’s pain.
Direct Stimulation for Managing Acute and Chronic Pain
Direct nerve stimulation – from an electrical result in a goal nerve, and never just via the skin through an electrode – can cancel the transmission of pain signals and supply a pleasing sensation within the goal area. Some patients relate the sensation of a peripheral nerve stimulation device to a massage or pins and needles.
Peripheral nerve stimulation is usually a long-term solution, however it just isn’t typically everlasting. For patients with acute postoperative pain – akin to patients recovering from a joint alternative akin to a complete knee or hip arthroplasty – direct peripheral nerve stimulation could be an efficient postoperative pain management tool. For patients with chronic neuropathic pain, akin to diabetic neuropathy, peripheral nerve stimulation could be an awesome alternative to opioids.
Preparing for Peripheral Nerve Stimulation
How does an individual insert an electrical lead the width of a human hair into the body? Via ultrasound, after all.
Peripheral nerve stimulation often begins in an outpatient facility like a specialized pain clinic. A health care provider disinfects and locally anesthetizes the initial injection site, then uses an x-ray or ultrasound imaging system to guide the lead through the body to the goal nerve utilizing a special needle. Then, a transmitter is placed on or under the skin, and patients receive a wireless device – often Bluetooth – to regulate the heart beat.
Not all pain patients are ideal candidates for peripheral nerve stimulation. It’s often more prone to be an option for you if:
- You might be at a greater risk of developing problems with opioid medication or have had problems with opioids.
- Your pain is attributable to peripheral neuropathy.
- You don’t want to have a more invasive procedure like surgery.
- Other more conservative methods – akin to physical therapy – didn’t help.
- Your pain just isn’t otherwise “easily” correctible.
Depending on the consequence of your treatment, the following step after a peripheral nerve stimulation could also be to think about a nerve block.
