Peripheral Nerve Stimulation

Peripheral nerve stimulation is an effective treatment for chronic painful conditions, including peripheral neuralgias, cranial neuralgias, chronic low back pain, plexopathies, complex regional pain syndrome, and chronic pelvic pains. Its utility is expanding, especially in treatment of pain that is minimally relieved from conservative measures, including nerve blocks. Percutaneous implantation of the lead is allowing for a less invasive approach and less costly option for peripheral nerve stimulation, with newer devices having external pulse generators or transmitters. The percutaneous technique requires a skilled provider comfortable with ultrasound or fluoroscopic guidance and familiarity with the device being utilized. In this chapter, we will discuss peripheral nerve stimulation as a treatment option in chronic pain, including the pathophysiology, indications, surgical and percutaneous implantation techniques, and other considerations to improve provider comfort with the procedure and patient outcomes.