Neuromodulation
Targeted Peripheral Nerve Stimulation | Austin, TX

Peripheral Nerve Stimulation

Minimally invasive electrical stimulation delivered directly to peripheral nerves — a precise, reversible option for focal neuropathic pain.

Overview

Peripheral nerve stimulation (PNS) delivers targeted electrical stimulation directly to a peripheral nerve — outside the spinal canal — to modulate pain signals at their source. Unlike spinal cord stimulation, which targets the central nervous system, PNS targets the peripheral nervous system: the specific nerve responsible for a patient's focal pain. This makes PNS particularly valuable for pain confined to a specific nerve distribution — such as post-surgical nerve injuries, limb pain, occipital neuralgia, or shoulder pain. Dr. Migdale is certified in the SPRINT PNS System (May 2025) and has specific clinical and research experience in intercostal PNS for post-mastectomy and post-thoracotomy pain.

How Peripheral Nerve Stimulation Works

PNS leads are placed percutaneously (through the skin with a needle, without open surgery) near the target peripheral nerve using ultrasound or fluoroscopic guidance. The lead delivers low-level electrical pulses that modulate pain signaling in the nerve — reducing abnormal pain transmission without blocking normal function. Modern PNS systems can provide meaningful relief with minimal stimulation, and many patients report that stimulation 'quiets' their pain rather than masking it.

The SPRINT PNS System

The SPRINT Peripheral Nerve Stimulation System (SPR Therapeutics) is an FDA-cleared PNS device designed for temporary percutaneous use — typically 60 days. Unlike permanent PNS implants, SPRINT uses a percutaneous lead that is placed and removed without surgery, making it both a therapeutic and a diagnostic tool. Evidence supports SPRINT for shoulder pain, low back pain, and various peripheral nerve pain conditions. Dr. Migdale completed SPRINT PNS education certification in May 2025.

Applications

PNS is used for: post-surgical neuropathic pain (intercostal, post-mastectomy, post-thoracotomy); occipital neuralgia and refractory headache; shoulder pain; knee pain; ankle and foot pain; phantom limb pain; and peripheral nerve injuries. The ability to target any accessible peripheral nerve makes PNS one of the most versatile tools in the neuromodulation toolkit.

Common Questions

Frequently Asked Questions

Is peripheral nerve stimulation the same as TENS?
No. TENS (transcutaneous electrical nerve stimulation) delivers stimulation through electrodes on the skin surface and does not implant leads. PNS places leads percutaneously adjacent to the specific nerve, providing much more targeted and potent stimulation. TENS provides temporary surface-level relief; PNS targets the nerve directly and can provide sustained, meaningful pain reduction.
Can peripheral nerve stimulation be removed?
Temporary PNS systems like SPRINT are designed for percutaneous placement and removal — no surgery required for either step. Permanent PNS implants require minor outpatient surgery for placement and removal, but the procedure is much less involved than SCS implantation.
What peripheral nerves can be targeted?
PNS can target any peripheral nerve accessible to percutaneous lead placement under image guidance. Most commonly targeted nerves include: occipital nerves (headache, occipital neuralgia); suprascapular nerve (shoulder pain); intercostal nerves (chest wall, post-surgical pain); femoral nerve (anterior thigh/knee pain); tibial and peroneal nerves (foot and ankle pain); and residual limb nerves (phantom limb pain).

Medical Disclaimer: The information on this page is intended for general educational purposes only and does not constitute medical advice. Individual results vary. This is not a substitute for professional medical evaluation, diagnosis, or treatment. Consult Dr. Migdale or another qualified healthcare provider regarding your specific situation.

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