Electrical stimulation in peripheral nerve injuries: A review of current literature

Peripheral nerve injuries (PNIs) are a common consequence of trauma, often affecting the upper extremity. These injuries can cause debilitating sensory and motor disturbances and are frequently treated by orthopedic hand and plastic surgeons. When the connective tissue surrounding the nerve fibers is maintained, PNIs may spontaneously heal without intervention. However, in more significant injuries in which endoneurial tissue is disrupted, surgical treatment may be more appropriate. Due to the complex regenerative process and concurrent limitations of peripheral nerve healing, sensory and motor function may still be restricted following surgery. Thus, there is growing interest in alternative or adjunct therapies for PNIs, with electrical stimulation (ES) showing great promise. The aim of this literature review was to explore the potential of ES as an adjunct therapy for PNIs, drawing insights from published in vitro, animal, and clinical studies. The findings demonstrate that ES can enhance the varying mechanisms of peripheral nerve regeneration by increasing intracellular calcium influx, upregulating regeneration-associated genes and neurotrophic factors, accelerating axonal outgrowth, and promoting functional recovery. ES shows promise, but large-scale studies are needed to assess its safety and efficacy before it can be standard of care for PNIs.