Peripheral nerve stimulation for neuropathic pain

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Neurotherapeutics. 2008 Jan;5(1):100-6.

Peripheral nerve stimulation for neuropathic pain.

Slavin KV.

Department of Neurosurgery, University of Illinois at Chicago,

Chicago, Illinois 60612, USA.

Peripheral nerve stimulation (PNS) has been used for treatment of

neuropathic pain for more than 40 years. Recent resurgence of

interest to this elegant surgical modality came from the introduction

of less invasive implantation techniques and the wider acceptance of

neuromodulation as a treatment of medically refractory cases.

This article reviews the literature on the use of PNS for neuropathic

pain and describes current indications and hardware choices in

frequent use. Published experience indicates that neuropathic pain

responds to PNS in many patients. PNS works well in both established

indications, such as post-traumatic and postsurgical neuropathy,

occipital neuralgia, and complex regional pain syndromes, and in

relatively new indications for neuromodulation, such as migraines and

daily headaches, cluster headaches, and fibromyalgia.

Future research and growing clinical experience will help in

identifying the best candidates for PNS, choosing the best procedure

and best hardware for each individual patient, and defining adequate

expectations for patients and pain specialists.