Pain Management Procedures
Peripheral Nerve Stimulation
Peripheral Nerve Stimulation
What is peripheral nerve stimulation?
Peripheral nerve stimulation, or PNS, uses a thin electrode placed near a named nerve outside the brain and spinal cord. Gentle electrical pulses change pain signaling in that nerve's distribution. Systems may be temporary, with a lead removed after a defined treatment period, or fully implanted for longer use.
When may it be recommended?
PNS may be considered for well-localized chronic pain that follows a specific peripheral nerve and has not improved enough with medication, therapy, injections, or other care. Examples include certain mononeuropathies, postsurgical or post-traumatic nerve pain, and selected shoulder or knee pain. A diagnostic nerve block may help identify the target, but device criteria vary.
What happens?
Using ultrasound or X-ray guidance, the clinician positions the electrode close enough to stimulate the target nerve without entering it. A temporary system connects to an external pulse generator; a permanent system includes an implanted receiver or generator. Programming is adjusted to produce useful coverage and function.
What should I expect?
Activity restrictions protect the lead and insertion site. You may feel tingling with some systems; others are designed to work without a noticeable sensation. Goals should include function, sleep, or reduced medication burden as well as pain scores.
Important risks
Risks include infection, bleeding, skin irritation, lead movement, lead fracture, unwanted stimulation, nerve injury, and device failure. Temporary systems still use a percutaneous implanted lead and require careful site care. Insurance coverage and authorization depend on the device and diagnosis.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.