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Stimulation of the Peripheral Nerve and Peripheral Nerve Field

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Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches

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Abstract

Neuromodulation by stimulation is most likely active by changing the balance in excitatory and inhibitory fibers based on the theory of Melzak and Wall. Since its introduction, neuromodulation strategies have progressively been advancing into the periphery. Peripheral nerve stimulation (PNS) is the direct electrical stimulation of named nerves outside of the neuroaxis. Peripheral nerve field stimulation (PNFS) is the stimulation of unnamed small nerves in the vicinity of pain by superficial, subcutaneous lead placement. Historically, PNS can be performed via an open surgical or percutaneous technique, well described by Stanton-Hicks. The percutaneous technique for both PNS and PNFS has now become more common and presents less risk and invasiveness to the patient. Because of this evolution to less invasive therapies, and the applicability to modern pain practice, this chapter will focus on these more practical approaches to targeting the nervous system.

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Author information

Authors and Affiliations

  1. Napa Pain Institute, Queen of the Valley, St Helena Hospital, 3434 Villa Lane, Suite 150, Napa, CA, 94558, USA

    Jason E. Pope M.D. & Eric J. Grigsby M.D.

  2. Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN, USA

    Jason E. Pope M.D.

  3. The Center for Pain Relief, 400 Court Street, Suite 302, Charleston, WV, 25301, USA

    Timothy R. Deer M.D.

  4. Department of Anesthesiology, West Virginia University School of Medicine, Charleston, WV, USA

    Timothy R. Deer M.D.

  5. Center for Interventional Pain & Spine, 4701 Ogletown-Stanton Road, Suite 2131, Newark, DE, 19713, USA

    Philip S. Kim M.D.

Authors
  1. Jason E. Pope M.D.
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  2. Timothy R. Deer M.D.
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  3. Eric J. Grigsby M.D.
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  4. Philip S. Kim M.D.
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Corresponding author

Correspondence to Jason E. Pope M.D. .

Editor information

Editors and Affiliations

  1. The Center for Pain Relief, Inc., West Virginia University, 400 Court Street, Suite 100, Charleston, 25301, West Virginia, USA

    Timothy R. Deer

  2. Stanford Pain Management Center, Redwood City, CA, Clinic Chief, Stanford University School of Medicine, Stanford, 94065, California, USA

    Michael S. Leong

  3. Department of Anesthesiology, Rush Medical College, Professor, Rush University Medical Center, Chicago, 60612, Illinois, USA

    Asokumar Buvanendran

  4. Pennsylvania State University, College of Medicine, Department of Anesthesiology, Milton S. Hershey Medical Center, Hershey, 17033-0850, Pennsylvania, USA

    Vitaly Gordin

  5. Center for Interventional Pain and Spine, Newark, DE USA, Medical Director, Bryn Mawr Hospital, Bryn Mawr, 19010, Pennsylvania, USA

    Philip S. Kim

  6. President, National Institute of Pain, Tampa, 33558, Florida, USA

    Sunil J. Panchal

  7. The LITE Center, Clinical Associate Professor, Medical Director, School of Medicine, Miami, 33143, Florida, USA

    Albert L. Ray

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© 2013 American Academy of Pain Medicine

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Pope, J.E., Deer, T.R., Grigsby, E.J., Kim, P.S. (2013). Stimulation of the Peripheral Nerve and Peripheral Nerve Field. In: Deer, T., et al. Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1560-2_57

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  • DOI: https://doi.org/10.1007/978-1-4614-1560-2_57

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-1559-6

  • Online ISBN: 978-1-4614-1560-2

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