Electrical Nerve Stimulation for Chronic Pain

Treatment Overview

Electrical nerve stimulation is a procedure that uses an electrical current to treat chronic pain. Peripheral nerve stimulation (PNS) and spinal cord stimulation (SCS) are two types of electrical nerve stimulation. In either, a small pulse generator sends electrical pulses to the nerves (in peripheral nerve stimulation) or to the spinal cord (in spinal cord stimulation). These pulses interfere with the nerve impulses that make you feel pain.

Nerve stimulation is done in two steps. To see if it will help your pain, your doctor will first insert a temporary electrode through the skin (percutaneously) to give the treatment a trial run. The electrode is connected to a stimulator that the patient can control. If the trial is successful, your doctor can implant a permanent stimulator under your skin. This is typically done using a local anesthetic and a sedative. The stimulator itself is implanted under the skin and the small coated wires (leads) are inserted under the skin to the point where they are either connected to nerves or inserted into the spinal canal.

After this outpatient procedure is complete, you and your doctor determine the best pulse strength. You are then told how to use the stimulator at home. A typical schedule for spinal cord stimulation is to use it for 1 or 2 hours, 3 or 4 times a day.

When in use, electrical nerve stimulation creates a tingling feeling.

What To Expect

You will have a small incision. You will need to keep it clean and dry until it heals.

Why It Is Done

This treatment may be done for people with severe chronic pain who have:

• Failed back surgery syndrome.
• Severe nerve-related pain or numbness.
• Chronic pain syndromes, such as complex regional pain syndrome.

Electrical nerve stimulation may be used for other conditions, including multiple sclerosis and severe angina.

How Well It Works

Experts still aren't sure how treatments like spinal cord stimulation and peripheral nerve stimulation help with pain. They don't help for all types of chronic pain. But are generally tried when other treatments haven't worked.

Spinal cord stimulation has been found to be helpful for certain types of chronic pain, such as failed back surgery syndrome and complex regional pain syndrome.

Peripheral nerve stimulation helps certain types of chronic pain, such as peripheral nerve pain and pain after surgery.

These types of treatment don't work for everyone. But they may help reduce pain over the long term. And they may help reduce the use of pain medicine in some people.

After initial pain relief, these treatments may be less effective over time. This is caused by the body getting used to the treatment.

Risks

Possible risks related to electrical nerve stimulation include:

• Scar tissue (fibrosis) developing around the electrode.
• The leads that carry the electrical current moving out of place.
• Breakage of an electrode or hardware failure.
• Infection.
• Leakage of spinal fluid during spinal cord stimulation.
• Headache from spinal cord stimulation.

Some people who have an implanted stimulator may not be able to have a magnetic resonance imaging (MRI) test. If you have an appointment for an MRI, be sure to take the device card that was given to you when you got your implanted stimulator. The imaging staff will know if it is safe for you to have an MRI.