Peripheral Nerve Stimulation in Pain Management: A Systematic Review.

Area of Science:

• Neurology
• Pain Management
• Evidence-Based Medicine

Background:

• Peripheral nerve stimulation (PNS) is increasingly utilized for acute and chronic pain management.
• The clinical evidence supporting PNS efficacy requires thorough evaluation.

Purpose of the Study:

• To systematically review and assess the clinical evidence for PNS in treating acute or chronic pain.
• Evaluate the efficacy and safety of PNS interventions.

Main Methods:

• A comprehensive systematic review of randomized trials, observational studies, and case reports up to December 2019.
• Utilized established quality appraisal tools and best evidence synthesis principles.
• Included 227 studies in the qualitative synthesis.

Main Results:

• Level I and II evidence supports PNS for chronic migraine.
• Level II evidence exists for cluster headache, postamputation pain, chronic pelvic pain, and chronic low back/lower extremity pain.
• Level IV evidence was found for peripheral neuropathic and postsurgical pain.

Conclusions:

• PNS demonstrates potential efficacy for chronic headaches, postamputation pain, chronic pelvic pain, and chronic low back/lower extremity pain.
• Variable levels of evidence support the use of PNS for these conditions.
• A significant limitation is the lack of high-quality randomized controlled trials.