An update on peripheral nerve stimulation

Electrical stimulation of peripheral nerves is an established modality in treatment of chronic pain. Although introduced half a century ago, it has enjoyed rapid growth in popularity and acceptance over the last decade or so. The spectrum of clinical situations where peripheral nerve stimulation (PNS) has been successfully used includes chronic pain in extremities, neck, lower back, chest and abdominal wall, and head and face regions. Based on several multicenter studies, PNS has been recently approved for clinical use in Europe for treatment of chronic low back pain and intractable chronic migraines. Such administrative recognition of clinical value of PNS necessitates update on PNS status for interested readers. The goal of this article is to provide a comprehensive overview of the different types of peripheral neurostimulation that are used today and providing the most updated information on the current state of the modality. As clinical interest and experience with PNS continue to grow, we expected steady accrual of objective evidence in terms of safety, efficacy, best indications and optimal stimulation parameters, all of which will be necessary for worldwide regulatory approval of PNS and for the benefit of patients who are still suffering from chronic neuropathic pain.