Nerve Stimulation Options for Peripheral Neuropathy
Spinal cord stimulation (SCS) has been used for over 50 years to alleviate pain for peripheral neuropathy. According to the International Neuromodulation Society, SCS is a neuromodulation therapy that interacts with the central, peripheral or autonomic nervous system for therapeutic effect by means of targeted electrical stimulation or pharmacological delivery from implanted devices. SCS is a lead that is implanted through epidural needles placed in the epidural space in the dorsal column. SCS sends mild electrical stimulation to the nerves along the spinal column. This disrupts the neuropathic (pain created by the nervous tissue) activity and reduces the pain sensation from reaching the brain. Below are common nerve stimulation options:
Nerve root stimulation
A neuromodulation used to treat chronic pain from peripheral neuropathy. The electric impulses are transmitted to one or more nerve roots along the spinal column. Nerve root stimulation can be used alone or with SCS.
Peripheral field nerve stimulation
A neuromodulation technique used to alleviate moderate to severe long-term pain. The implant is placed near peripheral affected nerves to emit mild electrical impulses. For example, occipital nerve stimulation helps manage severe headaches such as migraine, cluster headaches, and hemicranias continua.
High frequency spinal cord stimulation
A recent discovery indicates using high frequency pulses, rather than low frequency provides relief of back and leg pain. Therapeutic frequencies at 1 K to 10 KHz make the patient unaware of the stimulation to reduce peripheral neuropathy.
Dorsal Root Ganglion (DRG) stimulation
In DRG stimulation, small electrodes with 4 contacts are threaded in the epidural space parallel to the sensory dorsal root ganglia. This therapy is applied to the dorsal root ganglia in treating mainly groin and foot pain. This allows stimulation to specific nerve roots or parts of the nerve roots.
Burst spinal cord stimulation
A new stimulation waveform uses high-frequency current in relieving pain without presenting with any tingling sensation known as paresthesia. The nervous system communicates with itself in bursts of neural activity without patient awareness of the stimulation. The high energy stimulations show pain reduction up to 48 hours verses SCS delivers pain relief within 10-20 minutes of stimulation.