Peripheral nerve stimulation (PNS) is a drug-free treatment for chronic pain that comes from a specific nerve or area of the body. Max Shokat, D.O., a fellowship-trained, dual board-certified interventional pain physician, offers PNS trials for patients whose pain has not improved enough with medications, physical therapy or injections.

How does peripheral nerve stimulation work?

PNS uses mild electrical pulses delivered near a nerve to change how pain signals travel to the brain. A very thin wire, called a lead, is placed near the nerve that carries your pain and sends gentle pulses to it. Most patients feel a light tingling or nothing at all.

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What conditions may PNS help?

PNS may help reduce pain and improve function in selected patients with:

  • Chronic low back pain
  • Shoulder pain
  • Knee pain, including pain after knee replacement
  • Pain after surgery
  • Pain from a nerve injury
  • Headache and nerve pain at the back of the head (occipital neuralgia)

Dr. Shokat will review your history and exam to decide whether PNS is a good fit for you.

What is the process like?

PNS starts with a trial so you can see whether it helps before committing to an implant.

The trial. Dr. Shokat places a temporary lead through a needle near the painful nerve, using ultrasound or X-ray guidance and local anesthetic. There is no incision. You wear the stimulator at home for several days while you track your pain and activity.

Reviewing the results. At your follow-up visit, you and Dr. Shokat decide whether the trial gave you enough relief. The temporary lead is removed in the office.

The permanent implant. If the trial goes well, Dr. Shokat refers you to a partner surgeon to implant the Nalu system. This is a small device with no battery inside your body. It is powered by a small wearable unit you place over the implant when you want stimulation.

Dr. Shokat continues to follow your care after the implant.

Is PNS safe?

PNS is FDA-cleared for the treatment of chronic pain. The trial is low risk because the lead is temporary and placed through a needle. Possible risks include infection, skin irritation and movement of the lead. Dr. Shokat will review the risks with you before your trial.

Is PNS covered by insurance?

Many insurance plans, including Medicare, may cover PNS when coverage criteria are met. Our staff will check your benefits before your trial.

When will I notice results?

Most patients know during the trial whether PNS helps them. That is the purpose of the trial. Results after the permanent implant vary, and the settings can be adjusted at follow-up visits.