Peripheral Nerve Stimulation (PNS) in Castle Rock
What is Peripheral Nerve Stimulation?
Peripheral nerve stimulation (PNS) is a treatment that delivers mild electrical signals to a specific peripheral nerve to reduce pain. Unlike a spinal cord stimulator, which targets the spinal cord itself, PNS targets individual nerves outside the spine - in the arms, legs, shoulders, knees, or other areas where a specific nerve is causing chronic pain.
PNS works by modulating pain signals at the nerve level, reducing the intensity of pain your brain perceives. It can be an effective option for patients with chronic nerve pain in a specific area that has not responded to injections, medications, or physical therapy.
How is PNS Different from a Spinal Cord Stimulator?
Both SCS and PNS use electrical stimulation to modulate pain, but they target different parts of the nervous system.
Spinal cord stimulator (SCS): Leads are placed in the epidural space near the spinal cord. Best for widespread nerve pain, post-surgical spine pain, CRPS, and conditions affecting multiple nerve roots. More information is on the spinal cord stimulator page.
Peripheral nerve stimulator (PNS): A lead is placed near a specific peripheral nerve in the body. Best for localized pain from a single nerve or nerve territory - for example, chronic knee pain from a specific genicular nerve, shoulder pain, or pain from a peripheral nerve injury.
Dr. Carrera's team evaluates your pain pattern, history, and imaging to determine whether SCS, PNS, or another treatment is the best fit.
What Conditions are Treated with PNS?
Chronic knee pain (genicular nerve stimulation)
Shoulder pain from nerve injury or chronic rotator cuff issues
Post-surgical nerve pain (after knee replacement, shoulder surgery, or other procedures)
Peripheral nerve injuries
Occipital neuralgia (chronic headaches from irritated occipital nerves)
CRPS affecting a specific limb
Chronic pain in a specific nerve territory that has not responded to injections or medications
The Trial-First Approach
Like spinal cord stimulation, PNS uses a trial-first model. A temporary lead is placed near the targeted nerve and connected to an external device for about one week. During this time, you evaluate whether the stimulation provides meaningful pain relief during your normal daily activities. If the trial is successful (typically at least 50% pain reduction), a permanent implant can be considered.
If the trial does not provide adequate relief, the lead is removed and there is no lasting commitment.
What Happens During the Trial?
The trial procedure is performed at the outpatient surgery center under local anesthesia with light sedation. Using ultrasound or fluoroscopy for guidance, a thin lead is placed near the targeted nerve. The lead is secured to the skin and connected to a small external device. You go home the same day and use the device during normal activities for about one week.
What Happens After a Successful Trial?
If the trial provides meaningful relief, the team discusses options for a permanent or long-term device. Some PNS systems are designed for temporary use (60 days) while others involve a small permanent implant. The specific device recommended depends on the nerve being treated, the location, and your individual needs.
Does Insurance Cover PNS?
Coverage varies by insurance plan and the specific indication. Many commercial plans and Medicare cover PNS for certain conditions when documented criteria are met. The team handles prior authorization and can advise you on coverage for your specific situation.
Schedule a Consultation
If you have localized nerve pain that has not responded to injections or medications, peripheral nerve stimulation may provide targeted relief. Dr. Carrera's team can evaluate whether PNS is the right option for your specific pain pattern.