Peripheral Nerve Stimulation for Neuropathic Pain Management: A Narrative Review

Abstract

This narrative review examines the therapeutic efficacy of peripheral nerve stimulation (PNS) in the treatment of neuropathic pain (NP), a type of pain arising from lesions or diseases of the somatosensory system with a global prevalence ranging from 6.90% to 10.00%. Traditional pharmacological interventions often fall short for many persons, highlighting the need for alternative treatments such as PNS, which has demonstrated significant promise with minimal side effects. The review summarizes the effectiveness of PNS in various NP conditions, including trigeminal neuralgia and postherpetic neuralgia, and underscores the need for further research to refine treatment approaches. The mechanism of PNS is discussed, involving the activation of non-nociceptive Aβ fibers and modulation of neurotransmitters, and offering pain relief through both peripheral and central pathways. Despite the proven efficacy of PNS, challenges remain, including the need for randomized controlled trials and the optimization of stimulation parameters. The review concludes that PNS is a promising treatment modality for NP, warranting additional high-quality trials to solidify its role in clinical practice.

Keywords: Neuropathic pain; Painful diabetic neuropathy; Peripheral nerve stimulation; Postherpetic neuralgia; Trigeminal neuralgia.

Fig. 1

Depiction of gate theory. PNS could activate Aβ nerve fibers that cause activation of inhibitory interneurons, and also could inhibit Aδ and C fibers conduction and discharge within the dorsal horn. Then, it could decrease transmission to cortex. PNS peripheral nerve stimulation