What to Expect from Targeted Nerve Stimulation for Localized Pain
Peripheral nerve stimulation (PNS) uses a thin wire (lead), placed near a specific nerve outside the spine, to deliver mild electrical signals that calm pain coming from that nerve's territory. It is used for pain concentrated in one area, such as the shoulder, knee, low back, or a nerve injured during surgery. Some systems are temporary, worn for about 60 days and then removed, while others are permanently implanted.
Who May Be a Candidate
Chronic pain in one area that follows a specific nerve, such as after surgery or an injury.
Chronic low back pain related to the back muscles.
Chronic shoulder or knee pain, including pain after joint replacement.
Nerve pain such as occipital neuralgia, meralgia paresthetica, or groin pain after hernia repair.
People who prefer to avoid or are not candidates for spinal cord stimulation or surgery.
Types of Peripheral Nerve Stimulation
Temporary (60-day) PNS: A very thin lead is placed through a needle under ultrasound guidance and connected to a small wearable stimulator. After about 60 days, the lead is removed in the office. Some people get lasting relief even after removal.
Permanent implanted PNS: After a successful trial, a lead and a small receiver or battery are implanted for long-term use.
Before Your Procedure
Blood thinners: Any hold is coordinated with your prescribing doctor. Never stop a blood thinner on your own.
Skin care: Tell us about any rash or infection near the planned site.
Implanted devices: Tell us if you have a pacemaker, defibrillator, or other stimulator.
The Day of the Procedure
The skin is cleaned and numbed.
Using ultrasound (and sometimes x-ray), a needle is guided near the target nerve, and test stimulation confirms good coverage of your pain area.
The lead is placed and secured, and the needle is removed.
The stimulator is programmed before you leave.
Temporary PNS placement usually takes under an hour.
After Your Procedure
Keep the lead site clean and dry, and follow the bandage care instructions.
Avoid soaking in baths or pools while a temporary lead is in place.
Track your pain, activity, and sleep.
The temporary lead is removed at about 60 days in a quick office visit.
Continue physical therapy and home exercises.
Risks and Safety
Common: Mild skin irritation from the bandage or tape.
Uncommon: Lead movement or a broken lead fragment, which is usually left in place safely.
Rare: Infection or nerve irritation.
How Strong Is the Evidence?
Chronic low back pain (medial branch PNS): Level II · Prospective multicenter studies; NEURON consensus on neurostimulation for non-surgical low back pain (Deer et al., J Pain Res 2025)
Chronic shoulder pain (including post-stroke): Level I–II · Randomized trials
Post-surgical and post-amputation pain: Level II · Randomized and prospective studies
Occipital neuralgia / headache: Level II–III · Prospective studies and consensus statements
Evidence levels and guideline citations above are summarized for general clinical reference based on the literature and major society guidelines available at the time of writing. Guidelines are periodically updated; please verify current recommendations before relying on this summary for clinical decision-making.
Alternatives
Alternatives include nerve blocks, radiofrequency ablation or cryoneurolysis, spinal cord stimulation, medications, and physical therapy. We review the benefits and trade-offs of each with you.
Conditions This May Help
Talk With Us About Your Options
Call 650-507-4113 or send us a message to schedule a consultation at our Daly City, Los Altos, or Stockton office. We will review what may be causing your pain and walk through the risks, benefits, and alternatives of each option with you.
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This information is provided for general patient education and does not replace individualized medical advice. Please discuss your specific symptoms, diagnosis, and treatment options with your pain management physician.
