For the right patient, peripheral nerve stimulation is not just another treatment option. It is the first one that actually works.
What Is Peripheral Nerve Stimulation?
A minimally invasive therapy that goes directly to the nerve at the root of your pain.
Peripheral nerve stimulation is a neuromodulation therapy that places a small, flexible electrode lead directly alongside a specific peripheral nerve, outside the spine entirely. The lead connects to a pulse generator that delivers low-level electrical impulses, modifying how the nerve transmits pain signals to the brain. The result is targeted pain relief limited to the anatomical territory served by that nerve.
PNS is particularly valuable for patients whose pain is clearly localized to a defined area of the body and directly attributable to a specific nerve. Spinal-based approaches such as spinal cord stimulation or DRG therapy can miss these focal presentations entirely, because the pain distribution does not follow a broad spinal pattern. PNS fills that gap by going directly to the source.
At CURA Pain Management Centers in New Jersey, our board-certified specialists use ultrasound and fluoroscopic guidance to place PNS leads with precision, ensuring optimal proximity to the target nerve for maximum therapeutic effect.
Lead Placement
A flexible electrode is placed alongside the target nerve under ultrasound or fluoroscopic imaging guidance, precisely positioned for maximum effect.
Electrical Impulses Delivered
The pulse generator delivers low-level electrical pulses continuously, modifying how the nerve transmits pain signals toward the brain.
Abnormal Signaling Interrupted
Hyperactive, misfiring nerve activity is interrupted at the source before it can reach the central nervous system and register as pain.
Targeted, Lasting Relief
Pain reduction is confined precisely to the nerve’s anatomical territory, leaving surrounding areas completely unaffected.
Conditions Treated With Peripheral Nerve Stimulation
PNS is most effective when pain is clearly localized and attributable to a specific peripheral nerve.
Occipital Neuralgia and Chronic Migraine
Occipital nerve stimulation targets the greater and lesser occipital nerves at the back of the skull. It is highly effective for occipital neuralgia, intractable chronic migraine, and cluster headache unresponsive to medication. Patients often experience dramatic relief for pain that previously had no satisfactory treatment option.
Complex Regional Pain Syndrome (CRPS)
When CRPS affects a limb in a distribution that maps to a specific peripheral nerve, PNS offers a targeted alternative or complement to DRG or spinal cord stimulation. Stimulating the affected nerve directly can normalize aberrant pain signaling and reduce the allodynia, hyperalgesia, and autonomic changes that make CRPS so debilitating.
Post-Surgical Nerve Pain
Persistent neuropathic pain following hernia repair, knee replacement, shoulder surgery, or abdominal procedures is frequently undertreated. PNS directly targets the injured or entrapped nerve, producing superior results for these focal post-surgical pain syndromes compared to spinal-based approaches.
Chronic Knee Pain and Genicular Nerve Stimulation
Genicular nerve stimulation targets the small nerves supplying the knee joint capsule, offering a non-opioid, non-surgical option for patients with osteoarthritis or pain following total knee arthroplasty. Clinical evidence supporting this approach has expanded substantially in recent years.
Shoulder and Upper Extremity Pain
Chronic shoulder pain from brachial plexopathy, suprascapular nerve injury, or post-surgical changes responds well to targeted stimulation of the suprascapular or axillary nerves. PNS reaches pain that spinal-based approaches simply cannot address.
Abdominal, Groin, and Pelvic Nerve Pain
Chronic neuropathic pain from injury to the ilioinguinal, iliohypogastric, or genitofemoral nerves following surgery or trauma can be targeted directly with PNS, providing relief for patients who have not responded to medications or injections.
Peripheral Neuropathy and Nerve Entrapment
Focal peripheral neuropathy from entrapment or injury can be managed with PNS when the pain is clearly localized to a specific nerve’s territory. Common targets include the femoral, saphenous, sural, radial, and ulnar nerves depending on the pain distribution.
Who Is a Good Candidate for PNS?
The right patient profile makes all the difference in achieving a successful outcome.
Peripheral nerve stimulation is most effective in patients who meet several key clinical criteria. A comprehensive evaluation at CURA Pain Management Centers will assess each of these factors before any recommendation is made.
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✓Clearly Localized PainPain confined to a defined body region that maps to the territory of a specific peripheral nerve.
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✓Neuropathic in NaturePain arising from or sustained by abnormal nerve function rather than ongoing tissue damage alone.
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✓Failed Conservative TreatmentsMedications, physical therapy, and targeted injections have not produced lasting relief.
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✓Positive Diagnostic BlockA temporary nerve block targeting the same nerve has previously confirmed the pain source.
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✓Medically AppropriateNo active infection, coagulopathy, or other contraindication to implantable device placement.
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✓Psychologically ScreenedEvaluation confirms no untreated condition that would undermine implant outcomes.
Frequently Asked Questions
Common questions about peripheral nerve stimulation answered by our specialists.
Spinal cord stimulation places leads inside the epidural space and targets the dorsal columns, producing broad coverage across large areas of the body. Peripheral nerve stimulation bypasses the spine entirely, placing leads directly alongside a specific nerve outside the spinal canal. This makes PNS far more targeted, which is a major advantage for patients with focal, well-localized pain.
The implant is designed to be long-term but is fully reversible. The device can be turned off using a handheld controller, and the hardware can be surgically removed if desired. Because PNS does not destroy or permanently alter any tissue, removal is straightforward. The battery typically lasts several years, after which it can be replaced in a minor outpatient procedure.
The trial lead placement typically takes 30 to 60 minutes, performed outpatient under local anesthesia. The permanent implant procedure generally takes 60 to 90 minutes. Most patients are discharged the same day and return to light daily activities within a few days. Strenuous activity is restricted for 4 to 6 weeks to allow the implant site to heal.
The goal of PNS therapy is significant, meaningful reduction in pain rather than complete elimination. Most clinical studies define success as 50% or greater reduction in pain intensity, and many patients achieve results well above this threshold. During the trial period, you will experience firsthand how much relief the therapy provides before any permanent commitment is made.
Coverage varies by payer and indication. Occipital nerve stimulation, genicular nerve stimulation, and other PNS applications have varying coverage levels across Medicare and commercial insurers. Documentation of diagnosis, failure of conservative treatments, and a successful trial are typically required. CURA’s team conducts thorough insurance verification before proceeding.
Yes. PNS can be used as a standalone therapy or combined with other interventional and non-interventional approaches. Some patients benefit from combining PNS with spinal cord stimulation or DRG therapy when their pain has both a focal peripheral component and a broader spinal component. Your CURA physician will develop a comprehensive plan addressing all dimensions of your pain.
