Peripheral Nerve Stimulation for Chronic Pain: A Systematic Review of Effectiveness and Safety

Helm, Standiford; Shirsat, Nikita; Calodney, Aaron; Abd‐Elsayed, Alaa; Kloth, David; Soin, Amol; Shah, Shalini; Trescot, Andrea M.

doi:10.1007/s40122-021-00306-4

Cited by 48 publications

(31 citation statements)

References 147 publications

(130 reference statements)

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“…Therefore, we will focus our discussion on the possible opioidergic mechanisms of conventional SCS. Furthermore, to the extent that peripherally-targeted neurostimulation therapies such as peripheral nerve stimulation (PNS) ( Helm et al, 2021 ) and dorsal root ganglion stimulation (DRGS) ( Deer et al, 2017 ) engage the CNS, they are hypothesized to directly stimulate similar neural targets as conventional SCS ( Lin et al, 2020 ; Graham et al, 2022 ). Accordingly, in addition to potentially modulating action potential propagation in nociceptors, these therapies likely engage similar central analgesic mechanisms as with conventional SCS.…”

Section: Neurostimulation Therapies For Chronic Painmentioning

confidence: 99%

The role of endogenous opioid neuropeptides in neurostimulation-driven analgesia

Lubejko

Graham

Livrizzi

et al. 2022

Front. Syst. Neurosci.

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Due to the prevalence of chronic pain worldwide, there is an urgent need to improve pain management strategies. While opioid drugs have long been used to treat chronic pain, their use is severely limited by adverse effects and abuse liability. Neurostimulation techniques have emerged as a promising option for chronic pain that is refractory to other treatments. While different neurostimulation strategies have been applied to many neural structures implicated in pain processing, there is variability in efficacy between patients, underscoring the need to optimize neurostimulation techniques for use in pain management. This optimization requires a deeper understanding of the mechanisms underlying neurostimulation-induced pain relief. Here, we discuss the most commonly used neurostimulation techniques for treating chronic pain. We present evidence that neurostimulation-induced analgesia is in part driven by the release of endogenous opioids and that this endogenous opioid release is a common endpoint between different methods of neurostimulation. Finally, we introduce technological and clinical innovations that are being explored to optimize neurostimulation techniques for the treatment of pain, including multidisciplinary efforts between neuroscience research and clinical treatment that may refine the efficacy of neurostimulation based on its underlying mechanisms.

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Section: Neurostimulation Therapies For Chronic Painmentioning

confidence: 99%

The role of endogenous opioid neuropeptides in neurostimulation-driven analgesia

Lubejko

Graham

Livrizzi

et al. 2022

Front. Syst. Neurosci.

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“…Today, with newer devices on the market, complication rates seem to be lower, though data are very limited. Generally, peripheral nerve stimulators are considered safe and effective, despite a lack of sufficient data [ 55 ].…”

Section: Complications Of Peripheral Nerve Stimulationmentioning

confidence: 99%

“…al. published a case report of lead fracture as it crossed the shoulder joint [ 55 , 56 ]. Rarely reported are complications with the pulse generator including battery malfunction or positioning issues/pain.…”

Section: Complications Of Peripheral Nerve Stimulationmentioning

confidence: 99%

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Peripheral Nerve Stimulation in Painful Conditions of the Upper Extremity—An Overview

et al. 2022

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Our objective is to present a brief history of the evolution of peripheral nerve stimulation, the current understanding of peripheral nerve stimulation mechanisms in chronic pain, peripheral nerve stimulation applications in upper extremity chronic pain conditions, and complications of peripheral nerve stimulation. The evolution of peripheral nerve stimulation from the early ages to the current status has been facilitated by discoveries in neurobehavioral mechanisms of pain, advances in technology and percutaneous lead development, and the availability of high-quality portable ultrasound units. Peripheral nerve stimulation application in managing upper extremity pain of amputated limbs, post-stroke shoulder pain, complex regional pain syndrome (CRPS), and median, ulnar, and radial neuropathies are discussed. Finally, we describe complications of peripheral nerve stimulation. The availability of ultrasound-guided peripheral nerve stimulation techniques and superior peripheral nerve stimulation technology have opened up new and minimally invasive treatment options for chronic intractable neuropathic pain of the upper extremity. Additionally, the ability to place peripheral nerve stimulation leads percutaneously without open peripheral nerve surgery expands the pool of implanting physicians, while simultaneously decreasing the risks and complications that are associated with open surgery.

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“…Peripheral electrical stimulation (PES), the application of electrical currents delivered through transcutaneous or percutaneous electrodes to recruit efferent or afferent neural pathways, has been used in research and clinical rehabilitation [18][19][20]. PES may be able to modulate aberrant neural circuits, such as those observed with pathological tremor, by shifting the neural system's output towards more normal physiological states [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Non-invasive electrical stimulation of peripheral nerves for the management of tremor

Pascual-Valdunciel

Rajagopal²,

Pons

et al. 2022

Journal of the Neurological Sciences

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Peripheral Nerve Stimulation for Chronic Pain: A Systematic Review of Effectiveness and Safety

Abstract: Peripheral nerve stimulation (PNS) was the first application of neuromodulation. Widespread application of PNS was limited by technical concerns. Recent advances now allow the percutaneous placement of leads with ultrasound or fluoroscopic guidance, while the

Cited by 48 publications

References 147 publications

The role of endogenous opioid neuropeptides in neurostimulation-driven analgesia

The role of endogenous opioid neuropeptides in neurostimulation-driven analgesia

Peripheral Nerve Stimulation in Painful Conditions of the Upper Extremity—An Overview

Non-invasive electrical stimulation of peripheral nerves for the management of tremor

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