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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.
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
You will have a small incision that you
should keep clean and dry until it heals.
This treatment may be done for people
with severe, chronic pain who have:
Electrical nerve stimulation is typically considered
investigational for various other conditions, including
multiple sclerosis, paraplegia, and intractable
There isn't a lot of evidence to show how well spinal cord stimulation works. It seems to help certain types of chronic pain, such as failed back surgery syndrome and complex regional pain syndrome.1 Spinal cord stimulation may also help chronic low back pain.2
Some researchers have reported that
more than half of people receiving spinal cord stimulation for chronic low back and leg pain, ischemic leg pain (for example, from peripheral arterial disease), or complex regional pain syndrome have pain
reduction or relief.3
There is some evidence that peripheral nerve stimulation helps certain types of chronic pain, such as peripheral nerve pain and pain after surgery. Studies so far have been small.4
Initial pain relief is often followed by a
gradual decline in effectiveness. Apparently, this is caused by the body's increasing
tolerance to the treatment.
Possible risks related to electrical nerve stimulation
People with an implanted stimulator can't have magnetic resonance imaging (MRI) tests.
There is still
not strong proof that electrical nerve stimulation works. Better research is needed.
Treatment success varies widely and is influenced by the cause of pain.
Electrical nerve stimulation may be
recommended for some people who have certain types of
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
Mailis-Gagnon A, et al. (2004). Spinal cord
stimulation for chronic pain. Cochrane Database of Systematic Reviews (3).
Taylor RS, et al. (2005). Spinal cord stimulation for
chronic back and leg pain and failed back surgery syndrome: A systematic review
and analysis of prognostic factors. Spine, 30(1):
Cameron T (2004). Safety and efficacy of spinal cord
stimulation for the treatment of chronic pain: A 20-year literature review.
Journal of Neurosurgery, 100(3, Suppl Spine):
Raphael JH, et al. (2011). Randomized double-blind sham-controlled crossover study of short-term effect of percutaneous electrical nerve stimulation in neuropathic pain. Pain Medicine, 12(10): 1515–1522.
Current as of:
March 12, 2014
Anne C. Poinier, MD - Internal Medicine & Nancy Greenwald, MD - Physical Medicine and Rehabilitation
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