Chronic pain patients who have not experienced sufficient relief from traditional treatment approaches may be ideal candidates for peripheral nerve stimulation.
The peripheral nerve stimulator device can be recommended by your pain management specialist as part of your individualized treatment plan. Our pain treatment locations are located throughout Maryland, Pennsylvania, and Virginia.
What Patients Are Saying
Everyone at the office is so friendly and helpful.
From Sabrina at the front desk, to Esther, the nurse practitioner who we saw for the appointment, everyone was professional and courteous.
- Maria D.
After transitioning from a pain and spine doctor in Columbia, MD.. The intake staff member at Pain and Spine Specialist made the scheduling a breeze. They were able to get me in within a week.
- Rashawn JJ
I've been going to the office for at least a year now. Never have I had a poor visit. Staff are friendly, caring and compassionate. All the doctors / NP are Amazing. They actually care about each patients health.
- Debbie Lang
This is an office that exceeded my expectations. The doctor was a good listener and I was impressed with understanding of my pain and symptoms. Highly recommend!!! - Pain and Spine Specialists of Mount Airy.
- Jeanne Wagener
This practice- every member - has been exceptional in helping me to manage sever spinal stenosis. Every care provider ( and I’ve seen most over 3 years) listens carefully and works with me to seek the best treatment modalities.
- Eileen M
My medications are on point and my new injections are awesome! I get my 2nd injection on September 2nd and I can't wait! I couldn't ask for a better doctor than my doctor! I'm very happy with my treatment plan.
- Janeen R
All the people at the practice are very helpful and considerate. Dr. Gandhi listens to what you have to say and then makes his decision on how to proceed with care. Not a lot of doctors today do this so it's a welcomed change.
- Ken S.
I didn't feel judged or anything because I was trying to get help for my back pain. I had a very pleasant experience there to my surprise honestly. I would recommend this office to anyone who experiences severe pain.
- Heather D
Dr. Roa is such an amazing doctor! During my first visit he never tried to rush through my appt., he genuinely listened to all my concerns and then took his time to explain to me in detail all his recommendations and how they would help me.
- Nikki Walker
Always friendly, courteous, and efficient service. From the ladies, who work the front desk, to the nurses and the doctors. I've always had a good experience with the Harrisonburg office in Virginia.
- Krystal Shaffer
I have now been with Dr. Rao for 13 years. He is the most caring Doctor I have ever been to! Dr. Rao makes you feel very comfortable at all times. I would not want to go to any other Doctor... I go to the Hagerstown location, everyone is very nice
- Theresa R.
The entire staff from the folks at the front desk to the Nurse, to the Physicians Assistant to the scribe that records the visit for the doctor - (great idea so the Doctor can focus on the patient!!!)
- NVA F.
Insurance companies can make things complicated. Regardless, I have been treated by Dr. Rao for over 7 years. I receive the utmost respect. Office personnel are caring and friendly. This practice is highly respected.
- Heidi B.
Completely the best care you could want the staff is so pleasant and caring and the doctors have true heart for healing, love being a patient here would give 10 stars if I could & absolutely the most caring during my procedure with Dr B
- Cathern C.
I had been feeling ick and had a fever. I switched to a virtual appointment and was approved. It was wonderful getting to chat and talk about my concerns just as if I was there... A seamless and easy way to be seen if Covid is around.
- HeatherAnn L
They scheduled my appointment very quickly so that I can get to help that I needed immediately instead of like most places having to wait two to three weeks to get in I called and was able to be seen the next day
- John H.
Peripheral Nerve Stimulation Guide
Patients Seen Within Two Weeks
What Is Peripheral Nerve Stimulation?
Peripheral nerve stimulation (PNS) is a treatment for chronic pain that is used when other first-line pain management treatments, such as medications, physical therapy, and nerve blocks, have not previously worked. It is a common procedure and is considered to be very safe. There is no added risk of dependency forming that a patient may experience with opioid medications, which are often prescribed for pain. This is an outpatient procedure that is designed to help reduce pain specifically from damaged peripheral nerves.
This procedure uses a small, electrical device known as a peripheral nerve stimulator implant. A pain management doctor will identify which peripheral nerves have been damaged and the device will be implanted next to the nerve to “stimulate,” it and keep pain signals from traveling along the nerve and into the brain. The electrical device acts in a similar manner to a pacemaker, which is implanted into a patient's heart, and delivers a series of fast electrical impulses to the nerve or multiple nerves, and the patient will feel nothing more than a tingling sensation. After the device is implanted, patients are able to control the amount of stimulation by turning it off and on or adjusting the levels of stimulation with a small remote control. With this implant, patients are often able to regain control of their symptoms and take back their life from their pain.
What Are The Peripheral Nerves?
The peripheral nervous system is a network of nerves that are located outside the brain and spinal cord (or your central nervous system). The nerves in the peripheral nervous system branch out from the brain and spinal cord into all other parts of the body, your muscles and organs included. The two systems, the peripheral nervous system and central nervous system, work together by the nerves in the central nervous system sending information throughout the body via the nerves of the peripheral system so that these areas can react to stimuli.
The peripheral nervous system is further divided into the somatic nervous system and the autonomic nervous system. The somatic nervous system includes the sensory nervous system and transmits signals from the different senses, such as taste and touch. The autonomic nervous system pertains to involuntary functions and organs, such as breathing and heart rate.
The peripheral nerves are more susceptible to injury since they are not protected by the spinal column and skull, like the central nervous system is. When the peripheral nerves are damaged, it can lead to what is known as peripheral neuropathy.
Peripheral neuropathy is the direct result of a nerve injury and can cause disruptions to the brain’s ability to communicate with the muscles and organs. Peripheral neuropathy affects the systems that make up the peripheral nervous system, which are the motor nerves, sensory nerves, and autonomic nerves. Symptoms of peripheral neuropathy can be muscle weakness, painful cramps, possible muscle twitching, numbness (especially in the hands and/or feet), excessive sweating, fluctuations in blood pressure, and inability to tolerate temperature changes.
Peripheral Nerve Stimulation Trial
Once the patient decides to move forward with the procedure, they will need to follow certain steps first. The initial part of the process requires the patient to complete a psychological evaluation to ensure that they are emotionally ready to go through with the procedure, as elevated stress and anxiety levels can reduce the effectiveness of the peripheral nerve stimulator implant.
When the patient has successfully completed the psychological evaluation and been deemed a good fit for the procedure, they will then move on to a trial run to gauge their response before the device is permanently implanted. The doctor will put the temporary peripheral nerve stimulator in the correct position using fluoroscopy, which creates a real-time video of the movements inside the body using x-ray technology. Instead of the actual device that is used during the later procedure, the temporary implant involves one or two electrodes (wires) and they are placed along the damaged peripheral nerve. This process is done as an outpatient procedure so the patient may leave the doctor’s office the same day. The trial will take place for around 3-5 days, allowing the patient to see if their pain and other symptoms subside and if they want to continue to the next phase. When the trial ends the temporary electrodes are removed.
The Peripheral Nerve Stimulation Procedure
After the trial period has been successfully completed, the patient will then be able to have the permanent device implanted and will require minimally invasive surgery.
Before the procedure begins the patient will be taken to the operating room in order to be prepped by an attendant. The patient will also be able to ask any additional questions they may have. This prep time will involve cleaning the area of the back, in the exact location where the device will be inserted, with alcohol or another antiseptic solution. Local anesthesia will then be administered in order to numb the area and medication may also be given through an intravenous line (IV) in order to relax the patient if needed.
While the patient is lying face down on the operating table a small incision will be made by the surgeon. The targeted nerve will be identified and a small needle will be used to insert the device under the skin. The device includes permanent electrodes with extension wires that are plugged into an internal pulse generator, also called a battery. When the stimulator is in place then the electrical pulse settings are adjusted to provide pain relief as quickly as possible and can continue to be adjusted later on to the level the patient needs. The entire procedure should be completed around an hour or less.
Afterward, the patient will be discharged and may resume light daily activities after a few weeks, with a full recovery after 6-8 weeks. Even with restricted movement, it is encouraged for the patient to move enough to keep the muscles from becoming stiff, but avoid excessive bending and/or twisting. Also, they should avoid lifting heavy objects until the area is completely healed. The doctor will discuss all the things the patient should and should not do before they are discharged.
The peripheral nerve stimulator has been clinically shown to provide significant relief from chronic pain and can allow patients to return to a good quality life.
How To Get Started
If you would like more information about peripheral nerve stimulation or other pain management therapies we offer or our specialists, please call Pain and Spine Specialists and speak to our dedicated team to improve the quality of your life. You can call (301) 703-8767 (Maryland Locations), (724) 603-3560 (Pennsylvania Locations), or (540) 433-1905 (Virginia Locations) and schedule an appointment today. If you would like a comprehensive overview of peripheral nerve stimulation prior to your appointment, then we recommend watching our latest PNS Webinar here.
Treatments We Offer
- Spinal Cord Stimulation
- Injection Therapies
- Medication Management
- Intrathecal Pumps
- Occipital Nerve Blocks
- Alternative Therapies
- Radio Frequency Ablation
- Trigger Point Injections
- Epidural Steroid Injections
- SGB Injection for PTSD
- MILD (Lumbar Decompression
- Minuteman Spinal Fusion
- Peripheral Nerve Stimulation
- Lumbar Sympathetic Block
- Stellate Ganglion Blocks
Condition We Treat
At Pain and Spine Specialists, our team of physicians and nurse practitioners are committed to giving you the most effective treatment when treating your pain. We believe that all patients should have access to quality care, and that is why you can find us conveniently located throughout Maryland, Pennsylvania, and Virginia.
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