Peripheral Nerve Stimulation for Chronic Pain Relief

Chronic pain can significantly diminish the quality of life, impacting everything from daily activities to emotional well-being. When traditional pain management methods fall short, innovative solutions like Peripheral Nerve Stimulation (PNS) offer a new avenue for relief. This Innovative therapy involves the precise delivery of electrical impulses to specific nerves, effectively interrupting pain signals and offering the potential for long-lasting relief.

This blog post will explore the science behind PNS, examine its potential to provide lasting relief for various chronic pain conditions, and discuss why it’s considered a promising advancement in chronic pain management in Sydney.

What Is Peripheral Nerve Stimulation (PNS)?

Peripheral Nerve Stimulation involves the use of a small device to deliver electrical impulses to specific peripheral nerves, which are located outside the brain and spinal cord. These electrical impulses, offered by professionals, aim to modulate nerve activity, thereby reducing the sensation of pain.
The procedure is performed by reputed chronic pain clinics in Sydney and is minimally invasive. It typically involves implanting electrodes near the targeted nerves connected to a compact pulse generator. Additionally, patients can control the intensity and frequency of the stimulation, allowing for personalised pain management.

How PNS Differs from Other Neuromodulation Techniques?

While PNS shares similarities with other neuromodulation techniques like Spinal Cord Stimulation (SCS), it is distinct in its targeted approach. SCS involves placing electrodes near the spinal cord to modulate pain signals, whereas PNS focuses directly on the peripheral nerves associated with the pain. This direct targeting can lead to more effective pain relief for certain conditions, especially when specific nerves are identified as the primary source of pain.

How Does PNS Work to Relieve Pain?

PNS operates by sending mild electrical pulses to the peripheral nerves, which interfere with the transmission of pain signals to the brain. This interference can alter the perception of pain, effectively reducing or eliminating discomfort in the targeted area. The stimulation can be adjusted to meet individual needs, providing a customisable approach to pain relief.

One of the significant advantages of PNS is its precision. By focusing on specific nerves responsible for transmitting pain signals, PNS can provide targeted relief without affecting other bodily functions. This precision enhances the effectiveness of the treatment and minimises potential side effects, making it a compelling option for those seeking alternative treatments for back pain and other chronic conditions.

Benefits of Peripheral Nerve Stimulation
PNS offers several benefits, including the following:

Reduction in Chronic Pain Levels
Clinical studies have demonstrated that PNS can significantly reduce chronic pain levels. Patients often report decreased pain intensity and frequency, allowing them to engage more in daily activities. This reduction in pain can be particularly beneficial for individuals suffering from conditions that have not responded well to traditional treatments.

Minimised Dependence on Medication
A notable benefit of PNS is the potential to reduce reliance on pain medications. By providing effective pain relief through nerve stimulation, patients may find they require lower doses of medication or can eliminate them altogether. This reduction decreases the risk of medication-related side effects and dependency, promoting a healthier long-term outcome.

-Improved Quality of Life
With effective pain management, patients often experience improvements in their overall quality of life. Enhanced mobility, better sleep, and the ability to participate in social and recreational activities contribute to a more fulfilling life. Additionally, the psychological benefits of reduced pain can lead to improved mental health, underscoring the importance of comprehensive chronic pain management strategies.

Potential Side Effects of PNS
While PNS is generally considered safe, it is essential to be aware of potential risks and side effects. These may include infection at the implantation site, allergic reactions to device materials, or discomfort from the device itself.
Technical issues, such as lead migration or device malfunction, may occur in some cases. However, these occurrences are relatively rare, and many can be mitigated through proper surgical techniques and post-operative care.

Who Should Avoid PNS?

PNS may not be suitable for everyone. Individuals with certain medical conditions may need to avoid this treatment. Additionally, individuals with pacemakers or other implanted electronic devices should consult with their healthcare provider, as PNS may interfere with these devices. A thorough evaluation by a pain specialist is crucial to determine if PNS is an appropriate option.

Procedure and Implementation of PNS

The implementation of PNS typically begins with a comprehensive assessment by a pain specialist to identify the specific nerves involved in the patient’s pain. This assessment may also involve collaboration with a pain psychologist to address the psychological and emotional aspects often associated with chronic pain.

Once identified, a trial period may be conducted, during which temporary electrodes are placed near the targeted nerves to evaluate the effectiveness of the stimulation. If the trial is successful, a minor surgical procedure is performed to implant the permanent electrodes and pulse generator. The system is then programmed to deliver the optimal level of stimulation, and patients are educated on how to adjust settings as needed.

Conclusion:

By offering targeted, effective, and customisable pain relief, PNS provides hope for individuals seeking alternatives to traditional pain treatments in Sydney. For those exploring options for chronic pain management, consulting with a pain specialist about PNS could be a transformative step towards improved health and well-being.

Dr. Sally Wride

Originally from England, Sally graduated from St George’s Hospital, University of London in 2004 with a BSc (First Class Hons) in Physiotherapy. Since settling in Australia, Sally has worked in private practice and in the public hospital setting across Sydney.

Sally gained a Masters in Medicine Pain Management from the University of Sydney in 2019 and is a Titled Pain Physiotherapist (as awarded by the Australian Physiotherapy Association).

In addition to private practice, Sally currently works as a Senior Physiotherapist at Westmead Hospital Pain Management Service.

Sally is highly skilled in assessing, diagnosing and treating people who experience chronic pain. She enjoys working with injured workers and CTP claimants. She has a deep understanding of the impact of pain on the whole person and on their functioning in daily life. In partnership with her colleagues, Sally enjoys applying her knowledge and clinical skills to provide a safe space for exploration of the physical and emotional meaning of pain and for recovery of function.

Qualifications and Experience

Education
MSc in Medicine Pain Management (Sydney University) Accreditations

Dr. Baraa Kassim

Dr. Baraa Kassim is a highly skilled rehabilitation and pain management specialist. With experience in treating patients with complex medical conditions, her expertise spans strokes, neurological, orthopedic, musculoskeletal, and geriatric conditions, as well as spasticity management and spinal and brain injury rehabilitation.

Dr. Adam Mir

Dr. Adam is a Fellowship-trained Pain Medicine Specialist with a Fellowship from the Faculty of Pain Medicine (FFPMANZCA) and a Master of Pain Medicine from the University of Sydney. He is dedicated to the comprehensive management of chronic pain across all age groups.

Dr. Adam trained in adult pain medicine at Liverpool Hospital, Nepean Hospital, and the Department of Pain Medicine, and completed additional training in paediatric chronic pain at The Children’s Hospital at Westmead. He currently serves as a Staff Specialist at Westmead and St George Public Hospitals (NSW Health), and is a Visiting Medical Officer (VMO) at Liverpool Public Hospital, St George Private, Sydney Southwest Private, Holroyd Private, Norwest Private, and Nepean Private Hospitals.

He adopts a whole-person, multidisciplinary approach rooted in the socio-psycho-biomedical model, utilising both pharmacologic and interventional techniques. These include:

Dr. Adam is an Authorised Prescriber of Medicinal Cannabis and holds a Diploma in Medicinal Cannabis. He is also certified in Opioid Treatment Programs, including Methadone, Suboxone, and Buprenorphine injections. His areas of interest include opioid dependence management, medicinal cannabis, and interventional pain procedures.

He also completed advanced training in Virtual Reality Therapy for chronic pain and mental health disorders in Barcelona, Spain, and has further qualifications in Focused Psychological Strategies, Cognitive Behavioural Therapy (CBT), and Clinical Hypnosis.

Qualifications:

Languages Spoken: English, Persian (Farsi), Dari

Dr. Alister Ramachandran

Dr. Alister Ramachandran, a dual specialist in Anaesthesia and Pain Medicine, boasts 20+ years of experience. FIPP-certified, he leads Westmead’s pain service, teaches at Sydney University, and is a Faculty of Pain Medicine examiner. His focus remains on delivering evidence-based chronic pain treatment, ensuring comprehensive and effective pain management intervention.

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