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Peripheral Nerve Stimulation for Low Back Pain: A Systematic Review.
Ryan S D'Souza1, Max Y Jin2, Alaa Abd-Elsayed3
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN, USA.
Current Pain and Headache Reports
|April 15, 2023
Summary
Peripheral nerve stimulation (PNS) may offer modest pain relief for low back pain (LBP). However, evidence quality is low due to study limitations, suggesting further research is needed for this LBP treatment.
Area of Science:
- Neuromodulation
- Pain Management
- Spinal Cord Stimulation
Background:
- Low back pain (LBP) significantly impacts physical function, mental health, and quality of life.
- Peripheral nerve stimulation (PNS) is an emerging treatment for LBP.
- This review assesses the evidence for PNS efficacy in LBP management.
Approach:
- Systematic review of 29 articles.
- Included 828 participants using PNS for LBP as primary therapy.
- Included 173 participants using PNS as adjunctive therapy after spinal cord stimulation (SCS).
Key Points:
- PNS modalities include conventional PNS, peripheral nerve field stimulation (PNFS), and neuromuscular stimulation.
- Studies reported modest to moderate pain reduction with PNS compared to baseline.
- Evidence quality (GRADE) was very low, with some studies showing no difference versus sham/SCS, indicating potential placebo effects.
Conclusions:
- PNS, PNFS, and neuromuscular stimulation may offer some pain relief for LBP.
- Current evidence is limited by risk of bias, heterogeneity, and data inconsistency.
- Further high-quality research is necessary to confirm PNS efficacy for LBP.
