Peripheral Nerve Stimulation (PNS) and How It Helps Manage Back Pain

May 4, 2024

The terms mononeuritis and entrapment neuropathy cover a wide spectrum of nerve disorders and therefore may present unique challenges in pain management. In recent years, the use of peripheral nerve stimulation (PNS) has garnered attention as a promising treatment for some of these disorders. So, in this post, I will delve into clinical applications of PNS, shedding light on how it targets the middle and superior cluneal nerves to alleviate back pain.

Post-Sacroiliac Joint Fusion Surgery Back Pain: A Clinical Conundrum

Sacroiliac joint fusion surgery is a common intervention for addressing chronic sacroiliac joint dysfunction. However, some patients may experience persistent or new onset back pain after having the procedure. This lingering pain can be attributed to various factors, including the involvement of middle and superior cluneal nerves.

Understanding Superior and Middle Cluneal Nerves

The superior and middle cluneal nerves are branches of the posterior rami of spinal nerves arising from the thoracic and lumbar regions. These nerves innervate the skin overlying the sacral and lumbar regions, playing a crucial role in transmitting sensory information from these areas to the brain. When these nerves become compressed, irritated, or damaged due to various factors such as trauma, degeneration, surgery or anatomical abnormalities, they can trigger chronic low back pain, often characterized by a dull, burning, or tingling sensation.

Peripheral Nerve Stimulation: Precision in Mononeuropathy

PNS offers a precision targeted approach to mononeuropathy by delivering controlled electrical impulses to specific nerves. In the case of the middle and superior cluneal nerves, the implementation of electrodes near the affected area allows for neuromodulation, disrupting aberrant pain signals and providing relief. This precision makes PNS a potentially effective option to relieve neuropathic pain.

Navigating Challenges: Electrode Placement and Individual Variability

Achieving optimal outcomes with PNS requires meticulous attention to electrode placement. Individual anatomy necessitates precise positioning under fluoroscopic or ultrasound guidance. This tailored approach minimizes the risk of unintended effects and maximizes the therapeutic benefits of PNS for mononeuritis and entrapment neuropathy.

Clinical Evidence and Outcome

Scientific literature reveals a growing body of evidence supporting the use of PNS for mononeuropathy associated with the middle and superior cluneal nerves. Clinical studies showcase reductions in pain intensity, improvements in functional outcomes, and enhance patient reported quality of life. These findings underscore the therapeutic potential of PNS in modern neuropathy.

In conclusion, the utilization of a peripheral nerve stimulator for post-surgical back pain from SI joint fusion surgery leading to mononeuritis and/or entrapment neuropathy targeting the middle and superior cluneal nerves represents a significant stride in precision pain management. This scientific exploration underscores the intricate interplay between the anatomy, technology, and clinical outcomes.This offers a glimpse into the promising future of modulation as a transformative approach to post-surgical back pain resulting from mononeuritis and entrapment neuropathy.

So if you are still experiencing back pain after sacroiliac joint fusion surgery, it may be time to schedule an appointment with Dr. Manocha to learn more about PNS as a treatment option.