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Controlling Amputation-Related Pain Through Peripheral Nerve Stimulation

Posted by Bryan Potok, CPO on

For those who had ample time to prepare for their amputation surgery, one of the frequently asked questions is about residual limb and phantom limb pain—what to expect and how to manage it. Today, those who are considering an elective amputation have more pain control options, including peripheral nerve stimulation (PNS).

 Using Peripheral Nerve Stimulation to manage amputation-related pain.

A recent issue of inMotion magazine published an article on the effectivity of PNS. A 53-year-old nurse, Casandra Peterson, was able to prevent both residual limb and phantom limb pain during the first few months after her amputation.

Phantom limb pain afflicts 60%-80% of those who have undergone an amputation. In some cases, this type of pain does not resolve, affecting a person’s mobility and quality of life.

To stem both possibilities, Peterson’s healthcare team at the Hunter Holmes McGuire VA Medical Center presented her with the option of using a new procedure. It involved the implantation of an electrical device that would stimulate nerves to block both residual limb and phantom limb pain. The device was the Sprint PNSTMsystem by SPR Therapeutics.

Several days after amputation, the device was implanted near her nerve under ultrasound guidance. Then, a small plastic box was attached to Peterson’s skin through a pad. This box supplied the electrical current to the lead.

The box is light, and it features controls that could vary the intensity of the electrical stimulus so that the optimal level could be reached. New batteries are supplied by the healthcare team as necessary. While wearing the device, the user can take showers, but cannot swim. However, the device’s complication rate is generally low.

Other types of devices for PNS can be left implanted, but the one by SPR Therapeutics can stay inserted for 60 days, after which it had to be removed. But the good news is that the reduction of pain can continue a couple of months after the device is removed. The electrical signal blocks the transmission of pain signals from the nerve.   

According to the inMotion article, Peterson had a great experience with PNS; however, the results are inconclusive as of this writing. But based on what has already transpired, peripheral nerve stimulation suggests a promising and potentially powerful method of controlling pain related to amputation. Furthermore, although the number of providers that can perform and provide this treatment is currently limited, it is growing rapidly.

What are your thoughts on peripheral nerve stimulation? Would you be willing to try this treatment? Please share your thoughts in the comments section below.  
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  • Having CIDP (chronic inflammatory demylienating polyneuropathy) I chose to have a spinal stimulator implanted in my back, 1 in lower shoulder and 1 in upper hip area for pain control. This helped a lot for body pain. When I had to have amputation of leg below the knee I never had phantom pain and wondered if this was why. Reading this article, I think it may have. I’m glad to see the medical profession working on new alternatives for pain control.

    Sandra Gibson on

  • I am a 66 year old with a BKA post op 8 years. Exactly one week after the surgery, I began experiencing one of the most intense episodes of pain I had ever experienced. I have been through ovarian cancer, chemotherapy, and polio. One of the side effects of one of my chemo drugs was peripheral neuropathy and I was already on high doses of gabapentin but it did nothing to help this new pain. My surgeon knew immediately that I was suffering the same kind of neuropathy in my limb and told me that if we didn’t get it under control, it would likely continue forever. He immediately sent me to Interventional Anesthesiology where we discussed the implantation of a Medtronic Stimulator. There were certain protocols that needed to be followed and approval from the insurance company. By the time I finally received approval, 3 months had passed, I couldn’t wear a prosthesis and I was quite literally suicidal. My husband was afraid to leave me alone. The pain was a never ending, 24 hours a day, limb feeling like someone was taking a Bic lighter and running it along the suture line, over and over and over. I say all this to ask why would you want a temporary fix to what could be a lifelong pain. The device just doesn’t seem to be the best choice when you can go with a neurostimulator that will change your life. As soon as it was placed and adjusted to my specific needs, it was as if I could breathe again. It was a miracle to me. 4 weeks later I received my first prosthesis and I have never looked back. I would urge anyone to search out all the options available. The neurostimulator is placed in your back and the only thing you have to do is keep your battery charged.
    Thanks for letting me have this platform to share my experience.

    Janet Wingo on

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