Birds of a Feather Redux: Defining Ways to Stimulate the Peripheral Nervous System

Abstract

Peripheral nerve stimulation (PNS) has become an essential component in the pain management plan for individuals suffering from peripheral nerve-mediated pain. The recent surge in interest in PNS can be attributed to the advancements in imaging techniques and the availability of minimally invasive stimulation systems along with a deeper grasp of PNS physiology. These advancements have made PNS more accessible to clinicians and patients alike. However, it is important to note that PNS requires a different set of technical requirements and skills compared to other pain management procedures. The work, knowledge, and surgical and interventional skillset required for PNS are in a class of their own. This article aims to educate and clarify the differences between procedures that may have similar names but are vastly different in terms of technology, expertise, and skill sets necessary for their safe implementation. Some of the procedures that this article will cover include indirect peripheral nerve field stimulation (PNfS), indirect percutaneous electrical nerve stimulation (PENS), PENS-Field Stimulation (PENFS), and transcutaneous electrical nerve stimulation (TENS). By understanding the differences between these procedures, patients and health-care providers can make informed decisions about the best approach for managing pain.

Anatomo-physiological basis and applied techniques of electrical neuromodulation in chronic pain

“…Percutaneous Electrical Nerve Stimulation (PENS) is a procedure using thin needles inserted through the skin to deliver electrical impulses to specific nerves or tissues [ 188 ]. The objective is to alleviate persistent and chronic pain by stimulation of peripheral sensory nerves through the insertion of needles in the outer layers of the skin, characterized by high resistance [ 188 ].…”