Neuromodulation
Peripheral Nerve Stimulation
Focused neuromodulation beyond the spine
Peripheral nerve stimulation places a small lead near a selected nerve to modify localized pain signaling in areas such as the shoulder, knee, low back, or a post-surgical region.
This guide is educational and cannot determine candidacy. Every treatment has limitations and risks, and outcomes are not guaranteed. A clinician must review your diagnosis, health history, imaging, medicines, and goals.
What it targets
A procedure built for a particular pain mechanism.
PNS delivers mild electrical impulses near a named peripheral nerve. The stimulation can change how pain signals are transmitted and processed without destroying the nerve. Systems differ: some use a temporary percutaneous lead for a defined treatment period, while others use a trial followed by a longer-term implant.
Who may be evaluated
Candidacy begins with diagnostic fit.
PNS is considered only after the clinical team identifies a plausible peripheral nerve target and reviews simpler treatments, anatomy, and the goals of therapy.
Clinical considerations
- Localized chronic pain consistent with a peripheral nerve distribution
- Shoulder, knee, low-back, post-amputation, post-surgical, or other focal pain patterns in selected cases
- Persistent symptoms despite appropriate medication, rehabilitation, injections, or other conservative care
- A target that can be safely accessed under ultrasound or fluoroscopic guidance
- Realistic expectations for pain reduction, activity, and device management
Evaluation may include
- Neurologic and musculoskeletal examination to map the pain distribution
- Imaging or electrodiagnostic testing when needed to clarify the diagnosis
- Review of prior diagnostic nerve blocks and treatment response
- Psychological assessment and medical clearance when a permanent implant is being considered
How it is performed
The procedure, step by step.
Target confirmation
The physician selects the peripheral nerve and uses examination, imaging, and sometimes a diagnostic block to support the plan.
Lead placement
A thin lead is positioned near—not inside—the nerve under ultrasound or X-ray guidance, usually with local anesthetic and light sedation.
Programming and reassessment
The system is programmed to produce comfortable coverage, and follow-up focuses on symptom change, function, skin care, and lead stability.
After the procedure
Recovery, follow-up, and important risks.
Recovery & follow-up
- Most placements are outpatient procedures with a short monitoring period.
- Temporary systems require careful dressing and activity instructions while the external component is in use.
- Permanent systems involve additional implant healing and longer restrictions to reduce lead movement.
- The device is adjusted over time based on comfort and functional response.
Risks & limitations
- Infection, bleeding, nerve irritation or injury, and discomfort at the lead site
- Lead movement, breakage, skin irritation, or hardware malfunction
- Uncomfortable stimulation or insufficient benefit
- Additional procedures may be needed for revision, removal, or battery management
Alternatives to discuss
Evidence & technology
What is established—and what is still being studied.
Evidence in context
Evidence is strongest for selected neuropathic and postsurgical pain conditions; support varies by body region and device type. Joint-related pain applications are promising but do not have the same depth of evidence for every target.
Brands are examples, not endorsements
Temporary and implantable systems are available from multiple manufacturers. SPRINT and Nalu are examples; the practice's recommendation, if any, depends on the nerve target, duration strategy, imaging access, insurance criteria, and patient preference.
Common questions
A useful conversation starts here.
Related patient guides
Compare nearby clinical pathways.
Bring the questions with you
Find out whether the diagnosis fits the treatment.
Request an evaluation at one of our three South Florida offices.