Chronic peripheral nerve pain treated with direct electrical nerve stimulation.
Chronic somatic peripheral nerve pain was treated prospectively in 24 nonrandomized patients by a program of direct electrical nerve stimulation. Patients qualified for the program if anesthetic (lidocaine) nerve block of the involved cutaneous zone of the peripheral nerve relieved symptoms and transcutaneous electrical nerve stimulation transiently improved and did not exacerbate somatic pain. Results were judged according to a pain score. Patients noted improved sleep and complete absence of the need for narcotic pain medication. On the basis of subjective and objective criteria, 18 patients had good or excellent results and 6 had implant failures. Of the six patients with failures, three failed the trial period and did not have implantation, and three had no significant pain relief and were judged as treatment failures. Three patients had late equipment failure after initial good results. Most patients had some relief of pain, which increased their quality of life and eliminated the need for narcotic analgesia. Direct electrical nerve stimulation should be considered for somatic peripheral nerve pain that has not been ameliorated with other methods. It will reduce, although not necessarily eliminate, pain and pain behavior in most patients.
Strege
D W
DW
Division of Hand Surgery, Mayo Clinic, Rochester, MN 55905.
Cooney
W P
WP
Wood
M B
MB
Johnson
S J
SJ
Metcalf
B J
BJ
D000293:Adolescent; D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010148:Intractable Pain / Q000175:diagnosis / Q000628:therapy*; D017060:Patient Satisfaction; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome