Peripheral nerve stimulation (PNS) has emerged as a minimally invasive neuromodulation option for focal pain syndromes.1 While spinal cord stimulation (SCS) and dorsal root ganglion (DRG) stimulation are well established for specific indications of use, PNS occupies a narrower and continually developing clinical niche. Despite the development of minimally invasive percutaneous systems that can be placed to target peripheral nerves with ultrasound and fluoroscopic guidance, widespread adoption remains limited.

PNS delivers electrical stimulation to peripheral nerves to modulate afferent pain signaling. Unlike SCS or DRG, which provide broad regional vs lumbar dermatomal coverage, PNS is anatomically targeted to specific peripheral nerves to produce focal effects.2,3

Emerging evidence suggests that PNS neuromodulation occurs through interaction with neural pathways via effects on endogenous neurotransmission and interactions with the central nervous system which may affect neuroplasticity and pain perception.4,5,6