External Noninvasive Peripheral Nerve Stimulation Treatment of Neuropathic Pain: A Prospective Audit
Abstract
Background Peripheral nerve stimulation (PNS) is a neuromodulation technique in which electrical current is applied to the peripheral nerves to ameliorate chronic pain through preferential activation of myelinated fibres, inducing long-term depression of synaptic efficacy. External noninvasive peripheral nerve stimulation (EN-PNS) is a novel and simple form of PNS that involves stimulation via an external nerve-mapping probe that is placed on the skin and connected to a power source.Objectives We aimed to assess the clinical utility of EN-PNS in patients with refractory neuropathic pains referred to a tertiary pain treatment center.Methods We undertook a prospective audit of EN-PNS. Patients with a diagnosis of either complex regional pain syndrome or neuropathic pain after peripheral nerve injury who met inclusion criteria were included. Participants completed three stages of the audit: stage 1, six weekly outpatient treatment sessions; stage 2, six-week equipment home loan; stage 3, six weeks of no EN-PNS treatment. The primary outcome was the average post-treatment instantaneous pain intensity during the last week in stage 2 compared with baseline (11-point numerical rating scale).Results EN-PNS provided significant short-term pain relief (n = 20 patients, average reduction of 2.8 numerical rating scale points, 95% CI 1.6-4.0, p < 0.001, intention-to-treat analysis). Eight patients (40%) improved in several outcome parameters ("responders"), including quality of life and function.Conclusion In this first prospective report on the use of EN-PNS in neuropathic pain, this technology provided significant clinical benefit for some patients. Controlled studies are required to confirm our results and the place of EN-PNS in future neuromodulation treatment algorithms. Given the refractory nature of these conditions, these results are encouraging.
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Initial clinical trial results indicate the potential for huge benefit for external noninvasive peripheral nerve stimulation (EN-PNS), though the sample size was small.
“Initial clinical trial results indicate the potential for huge benefit, though the sample size was small [56].”
From Identification and Management of Chronic Pain in Primary Care: a Review (2016) · cites this paper as [56]
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- Authors
- Johnson, S., Ayling, H., Sharma, M., & Goebel, A.
- Affiliations
- Walton Centre (GB)
- Corresponding author
- Johnson, Selina
- Venue
- Neuromodulation: Technology at the Neural Interface
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 18
- Issue
- 5
- Pages
- 384-391
- ISSN
- 1094-7159 (ISSN-L)
- OpenAlex
- W2097356567
- Cited by
- 27
- References
- 30
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 3
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuromodulation Technology at the Neural Interface (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- neuropathic pain, complex regional pain syndrome, peripheral nerve injury, neuromodulation, refractory pain, analgesia, quality of life
- MeSH terms
- Electric Stimulation Therapy, Female, Follow-Up Studies, Humans, Male, Neuralgia, Pain Measurement, Prospective Studies, Treatment Outcome, Complex Regional Pain Syndromes
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