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Literature Review: Mechanism, Indications, and Clinical Efficacy of Peripheral Nerve Stimulators in Lower Extremity Pain

  • Neuropathic Pain (A Abd-Elsayed, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Lower extremity pain is deemed by Center for Disease Control and Prevention (CDC) to be a significant source of chronic pain in adults. If not appropriately managed, patients are subjected to risks of prolonged musculoskeletal dysfunction, disruption to quality of life, and elevated healthcare expenditures. Peripheral nerve stimulation (PNS) has shown great potential in recent years demonstrating efficacy in multiple diagnoses ranging from acute post-surgical pain to complex regional pain syndrome (CRPS). This study seeks to delineate efficacy of peripheral neuromodulation in the context of chronic lower extremity pain.

Recent Findings

Prevailing clinical studies demonstrate evidence levels ranging from II to V (Oxford Centre of Level of Evidence) in lower limb PNS, attaining positive outcomes in pain scores, opioid use, and quality of life measures. Nerves most frequently targeted are the sciatic and femoral nerves with post-amputation pain and CRPS most commonly investigated for efficacy.

Summary

PNS is a promising therapeutic modality demonstrated to be effective for a variety of nociceptive and neuropathic pain conditions in the lower extremity. PNS offers chronic pain physicians a powerful tool in the multi-modal management of lower limb chronic pain.

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Data Availability

No datasets were generated or analysed during the current study.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Department of Anesthesiology, Weill Cornell Medicine, 1300 York Ave, New York City, NY, 10021, USA

    Qing Zhao Ruan, Jason Chang & Daniel Pak

  2. Georgetown University School of Medicine, Washington, DC, USA

    Rajesh Supra

  3. Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School-Beth Israel Deaconess Medical Center, Boston, MA, USA

    Cyrus Yazdi & Christopher L. Robinson

  4. Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands

    Linda Kollenburg & Erkan Kurt

  5. Absolute Pain Management, Rockville, MD, USA

    David Reece

  6. Harvard Medical School, Brigham and Women’s Hospital, Department of Anesthesiology, Perioperative, and Pain Medicine, Boston, MA, USA

    Alexandra C. G. Fonseca

  7. Chronic Pain Medicine, Department of Anesthesiology, University of Wisconsin-Madison, Madison, USA

    Alaa Abd-Elsayed

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  1. Qing Zhao Ruan
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Contributions

QZR: Planned, wrote, and revised the manuscript. JC DP RS CY LK EK AF AA DR: Wrote, edited, and provided expertise. CLR: Planned, wrote, provided expertise, revised the manuscript and is the primary investigator.

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Correspondence to Qing Zhao Ruan.

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Ruan, Q.Z., Chang, J., Pak, D. et al. Literature Review: Mechanism, Indications, and Clinical Efficacy of Peripheral Nerve Stimulators in Lower Extremity Pain. Curr Pain Headache Rep (2024). https://doi.org/10.1007/s11916-024-01240-8

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