Peripheral nerve stimulation for chronic pain

Abstract

Electrical stimulation has been used since ancient times to treat painful conditions. Electrotherapy for pain was largely consigned to the realm of quackery until the introduction of the Gate Control Theory by Melzack and Wall in 1965 provided a rationale for direct stimulation of peripheral nerves. Since that time, peripheral nerve stimulation has been applied to the treatment of painful conditions throughout the body, beginning with the major nerves of the extremities and culminating today in precise subcutaneous field stimulation targeted to specific areas of neuropathic pain. This article reviews the history, development, and current areas of interest in peripheral nerve stimulation for the treatment of neuropathic pain.

Block of Peripheral Pain Response by High-Frequency Sinusoidal Stimulation

“…We have demonstrated complete block of the heat-induced potentiation of the sural-gastrocnemius reflex, showing no significant difference (p > 0.5) from the baseline case in all five nerves tested. While this is only a preliminary animal study, the results demonstrate an improvement over typical TENS, PNS, and SCS success rates in the literature (21)(22)(23)(24). While this may simply be due to the more straightforward and controlled nature of the study, the improvement over PNS suggests that this effect is not merely due to focusing the stimulation directly on the nerve of interest but may be due to a different mechanism of effect, as suggested by CNS studies (2,20).…”

The effect of effleurage and abdominal lifting massage in the labor pain

“…Massage aimed at influencing the motor, nervous and cardiovascular systems, triggering rest and relaxation throughout the body and breath. In addition, massage also aims to restore venous and lymph flow, stimulates the sensory receptors in the skin and sub skin to reduce the feeling of pain [17][18][19]. Besides, the relaxin hormone serves to relax ligaments in the pelvis for birthing process [8], this hormone also relaxes the ligaments supporting the spine thus triggering pregnancy pain.…”

Stimulation of the medial plantar nerve for complex regional pain syndrome

“…It was put forward that electrical stimulation reduces neuropathic pain by activating large diameter A-b fibers (which carry innocuous stimuli), which in turn inhibits small c and A-delta fibers, which carry nociceptive input to the brain. 9 This theory was tested clinically by Wall and Sweet in 1967 by implanting electrodes on the median and ulnar nerve. 10 Since then, many developments have been made in neuromodulation, and peripheral nerve stimulation has been shown to be an effective method of managing chronic neuropathic pain and causalgia.…”