Dual Peripheral Stimulation of Musculocutaneous and Radial Nerves for Refractory Upper Extremity Pain: Case Report

Peripheral nerve stimulation has been available for many years, yet there is relatively little information available regarding stimulation of many of the large sensory and mixed nerves.

A 42-year-old woman presented to the clinic for a 10-year history of intractable left upper extremity and forearm pain following a motor vehicle accident requiring skin grafting. Based on the patient's failure of more conservative therapy, a shared decision was made to pursue opioid sparing interventional modalities. Implantable radial and musculocutaneous nerve stimulators were chosen for this patient for ease of use and high likelihood of favorable outcomes.

Sequential radial and musculocutaneous stimulation provided a 45% and 50% reduction in pain respectively, with the summative reduction of pain from original presentation being greater than 72% relief in total.