Long-term pain control by direct peripheral-nerve stimulation.
Abstract
In 1970, we began implanting electrodes for prolonged stimulation of injured peripheral nerves to reduce chronic pain. Thirty-eight peripheral nerves in thirty-five patients have been stimulated with electrodes for a period ranging from four to nine years. Nineteen electrode systems were implanted in the upper extremity (eleven on the median nerve, six on the ulnar nerve, one on the median and ulnar nerves, and one on the median and radial nerves), with successful relief of pain in 52..6 per cent of the patients. Sixteen stimulators have been implanted on the sciatic nerve with a success rate for pain relief of 31 per cent. Failures in the lower extremity were found primarily in lesions of the posterior tibial nerve at the ankle. We speculate that the stress of weight-bearing and the anatomical position of the posterior tibial nerve may partially account for this rate of failure. Use of the electrode-implant systems required careful preoperative assessment by an experienced team, meticulous technique, and a mechanical system that tolerates stress. The location and characteristics of the lesion affect the response to electrical stimulation.
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FES has clinical applications for reducing pain.
“for reducing pain”
From A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems (2005) · cites this paper as Nashold et al., 1982
Extraneural electrodes have shown compatibility for up to 8 years stimulating the median, radial, sciatic, and ulnar nerves.
“up to 8 years stimulating the median, radial, sciatic, and ulnar nerves [39]”
From Safety of long-term electrical peripheral nerve stimulation: review of the state of the art (2019) · cites this paper as [39]
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“, 1997), for reducing pain (Nashold et al., 1982; Strege et al., 1994; StantonHicks and Salamon, 1997), for phrenic nerve pacing for ventilatory assistance (Glenn et al.”
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“Introduction Cuff electrodes have been widely used in neuroprosthetics with different applications such as footdrop correction by stimulation of the peroneal nerve in patients with hemiplegia [1]; stimulation of the median and ulnar nerves for pain control [2]; treatment of obstructive sleep apnea by stimulation of th…”
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“…inward sodium currents during the stimulation (Figure 4B), while non-symmetric waveforms cannot induce pulsed inward sodium currents either due to sodium channel deactivation by a constant hyperpolarization (Figures 6A,B) or sodium channel inactivation by a constant depolarization (Figures 7A,B).”
BackgroundInfluentialSpinal Cord and Peripheral Nerve Stimulation for Painful Disorders
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Neuromodulation: Spinal cord and peripheral nerve stimulation
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A New Treatment of Painful Amputation Neuroma: A Preliminary Report
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- Authors
- Nashold, B. S., Goldner, J. L., Mullen, J. B., & Bright, D. S.
- Venue
- The Journal of Bone & Joint Surgery
- Published
- 1982-01
- Volume
- 64
- Issue
- 1
- Pages
- 1-10
- ISSN
- 0021-9355 (ISSN-L)
- OpenAlex
- W1907072860
- Cited by
- 184
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 7 · 2020: 5 · 2019: 8 · 2018: 8 · 2017: 5 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 12 · 2012: 10
- FWCI
- 4.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Bone and Joint Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- peripheral nerve stimulation, chronic pain, peripheral nerve injury, median nerve, ulnar nerve, sciatic nerve, posterior tibial nerve, electrode implantation, analgesia, implant failure
- MeSH terms
- Adult, Aged, Electrodes, Implanted, Electric Stimulation Therapy, Female, Follow-Up Studies, Humans, Male, Median Nerve, Middle Aged, Nerve Block, Intractable Pain, Sciatic Nerve, Ulnar Nerve, Peripheral Nerve Injuries
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