High-Frequency Peripheral Nerve Stimulation May Effectively Treat Chronic Pain

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This double-blind study included 69 participants, 11 of whom received peripheral nerve stimulation and 58 of whom received spinal cord stimulation.
This double-blind study included 69 participants, 11 of whom received peripheral nerve stimulation and 58 of whom received spinal cord stimulation.

Peripheral nerve stimulation at 10 KHz was found to be efficacious in reducing chronic pain, according to a study published in Neuromodulation: Technology at the Neural Interface

This double-blind study included 69 participants, 11 of whom received peripheral nerve stimulation and 58 of whom received spinal cord stimulation. Implantations of peripheral nerve stimulators were located along the trunk of a limb nerve (n=4), along a branch of the trigeminal or occipital nerve (n=4), or in the S1 nerve root (n=1), ilioinguinal nerve (n=1), or genitofemoral nerve (n=1). Spinal cord stimulators were implanted in patients with spine pain (n=49), type I complex regional pain syndrome or peripheral neuropathic pain (n=5), pain in the abdomen (n=2), or pelvic pain (n=2). Both the study researchers and participants were blinded to the ON/OFF status of the stimulator.

Although both groups experienced sustained analgesia over the 12-month study period (F=87.7; P <.001), a greater decrease was reported by participants receiving peripheral nerve vs spinal cord stimulation (F=3.34; P =.04). Pain intensity was unchanged after 2 hours of peripheral nerve stimulation, but was reduced after 4 hours, with other sensory modalities unaffected at either duration. Peripheral nerve vs spinal cord stimulation also resulted in lower analgesic use (25.1±50.4 vs 62.8±93.9, respectively; P =.056), decreased physical disability (19.3±18.1 vs 36.6±18.5, respectively; P =.006), and high outcome satisfaction (4.45±0.69 vs 3.37±1.53, respectively; P =.001), as assessed during a clinical review 3-= to 6-months post-implantation.

 “[Peripheral nerve stimulation] at 10 kHz frequency demonstrated a significant reduction in pain scores when stimulation was conducted for at least four hours with patients and the investigator blinded to the ON/OFF status of the stimulator. The effects on peripheral sensory modalities were minimal, suggesting that conduction block may not be an important mechanism in achieving adequate analgesia,” concluded the investigators.

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Reference

Finch P, Price L, Drummond P. High-frequency (10 kHz) electrical stimulation of peripheral nerves for treating chronic pain: A double-blind trial of presence vs absence of stimulation [published online November 16, 2018]. Neuromodulation. doi: 10.1111/ner.12877

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