A Retrospective Analysis of 25 Cases With Peripheral Nerve Field Stimulation for Chronic Low Back Pain and the Predictive Value of Transcutaneous Electrical Nerve Stimulation for Patient Selection

Schwarm, Frank P.; Stein, Marco; Uhl, Eberhard; Maxeiner, H; Kołodziej, Małgorzata

doi:10.1111/ner.12890

Cited by 8 publications

(16 citation statements)

References 52 publications

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“…An additional study evaluated patients with a single therapy and had good results on pain reduction E141 PNS in Pain and reduction of anxiety and depression, highlighting a positive balance on the affective toll of chronic pain (90). A recent retrospective study evaluated the benefit and predictive value of TENS for PNFS (91). The latter was found to be superior in providing analgesia and QOL as measured via NRS-11, 5-level EQ-5D version (EQ-5D-5L), ODI, Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA), and the Client Satisfaction Questionnaire (CSQ-8).…”

Section: Back Painmentioning

confidence: 99%

Peripheral Nerve Stimulation in Pain Management: A Systematic Review

Xu¹,

Sun

et al. 2021

Pain Phys

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BACKGROUND: Peripheral nerve stimulation (PNS) has been increasingly used to manage acute and chronic pain. However, the level of clinical evidence to support its use is not clear. OBJECTIVES: To assess the clinical evidence of PNS in the treatment of acute or chronic pain. STUDY DESIGN: A systematic review of the efficacy and safety of PNS in managing acute or chronic pain. METHODS: Data sources were PubMed, Cochrane Library, Scopus, CINAHL Plus, Google Scholar, and reference lists. The literature search was performed up to December 2019. Study selection included randomized trials, observational studies, and case reports of PNS in acute or chronic pain. Data extraction and methodological quality assessment were performed utilizing Cochrane review methodologic quality assessment and Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment (IPM-QRB) and Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment for Nonrandomized Studies (IPM-QRBNR). The evidence was summarized utilizing principles of best evidence synthesis on a scale of 1 to 5. Data syntheses: 227 studies met inclusion criteria and were included in qualitative synthesis. RESULTS: Evidence synthesis based on randomized controlled trials (RCTs) and observational studies showed Level I and II evidence of PNS in chronic migraine headache; Level II evidence in cluster headache, postamputation pain, chronic pelvic pain, chronic low back and lower extremity pain; and Level IV evidence in peripheral neuropathic pain, and postsurgical pain. Peripheral field stimulation has Level II evidence in chronic low back pain, and Level IV evidence in cranial pain. LIMITATIONS: Lack of high-quality RCTs. Meta-analysis was not possible due to wide variations in experimental design, research protocol, and heterogeneity of study population. CONCLUSIONS: The findings of this systematic review suggest that PNS may be effective in managing chronic headaches, postamputation pain, chronic pelvic pain, and chronic low back and lower extremity pain, with variable levels of evidence in favor of this technique. KEY WORDS: Acute pain, chronic pain, neuromodulation, peripheral nerve stimulation

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Section: Back Painmentioning

confidence: 99%

Peripheral Nerve Stimulation in Pain Management: A Systematic Review

Xu¹,

Sun

et al. 2021

Pain Phys

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“…The majority of patients with chronic low back pain uses TENS in the multimodal pain therapy concept in an outpatient setting before PNFS trial phase. In previous retrospective studies TENS did not seem to be a predictor for patient selection and success of PNFS (32,34,37). Successful PNFS trial stimulation still seems to be the most reliable predictor, but there is a lack of studies in the current literature concerning this issue.…”

Section: Introductionmentioning

confidence: 83%

“…To relief the axial pain component PNFS has become an important option too. Different studies reported favorable clinical outcomes (29–36,42). This modality can be used as stand‐alone or as add‐on with SCS (32,43,44).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to TENS, PNFS leads are placed subcutaneously. Various studies reported favorable clinical outcomes in the treatment of low back pain using PNFS with subcutaneously placed leads within the area of maximal pain (maximal extension 15 × 15cm; “size of a hand”) (29–36). Preoperative patient selection plays a crucial role (28).…”

Section: Introductionmentioning

confidence: 99%

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The Predictive Value of Transcutaneous Electrical Nerve Stimulation for Patient Selection in Peripheral Nerve Field Stimulation for Chronic Low Back Pain: A Prospective Study

Schwarm

Ott

Nagl

et al. 2021

Neuromodulation: Technology at the Neural Interface

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“…Unfortunately, direct stimulation of a peripheral nerve may distribute the signal in a different dermatomal pattern that is achievable by TENS. TENS trials have no definitive relationship correlation with success in spinal cord or peripheral nerve stimulation (Kirsch et al, 1975;Picaza et al, 1977;Schwarm et al, 2019). Thus, TENS trial is not routinely recommended for consideration of success of PNS systems.…”

Section: To Trial or Not To Trialmentioning

confidence: 99%

A review of the bioelectronic implications of stimulation of the peripheral nervous system for chronic pain conditions

et al. 2020

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Background: Peripheral Nerve Stimulation has been used to treat human disease including pain for several decades. Innovation has made it a more viable option for treatment of common chronic pain processes, and interest in the therapy is increasing. Main body: While clinical data is forthcoming, understanding factors that influence successful outcomes in the use of PNS still needs to be delineated. This article reviews the evolution and bioelectronic principles of peripheral nerve stimulation including patient selection, nerve targets, techniques and guidance of target delivery. We collate the current evidence for outcomes and provide recommendations for salient topics in PNS. Conclusion: Peripheral nerve stimulation has evolved from a surgically invasive procedure to a minimally invasive technique that can be used early in the treatment of peripheral nerve pain. This review identifies and addresses many of the variables which influence the success of PNS in the clinical setting.

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A Retrospective Analysis of 25 Cases With Peripheral Nerve Field Stimulation for Chronic Low Back Pain and the Predictive Value of Transcutaneous Electrical Nerve Stimulation for Patient Selection

Cited by 8 publications

References 52 publications

Peripheral Nerve Stimulation in Pain Management: A Systematic Review

Peripheral Nerve Stimulation in Pain Management: A Systematic Review

The Predictive Value of Transcutaneous Electrical Nerve Stimulation for Patient Selection in Peripheral Nerve Field Stimulation for Chronic Low Back Pain: A Prospective Study

A review of the bioelectronic implications of stimulation of the peripheral nervous system for chronic pain conditions

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