gms | German Medical Science

Objective: Peripheral nerve field stimulation (PNFS) is a well-known modality in the treatment of chronic low back pain. Chronic pain is a relatively common result of severe skin damage from burns and in Lyme disease. Depending on the cause and degree of injury, most people can recover without serious health consequences. In case of chronic neuropathic pain syndromes, pain management options for these patients have been mostly limited to pharmaceutical treatments.

Method: Two female patients with a chronic neuropathic pain syndrome after a history of Borreliosis (Lyme disease) and one male patient with chronic neuropathic pain on the right collar following a skin-damage from a burn failed to respond to medication and physical therapy in a multimodal therapy concept. The patients were treated by peripheral nerve field stimulation. Afterwards the neurostimulator was implanted after significant pain relief with a minimum of 70%. The Visual analog scale (VAS) assessed pain before and after the implantation as well as 3 and 6 months postoperatively.

Results: Significant pain relief was achieved in all three patients. In the male patient the 10 point mean VAS score was reduced from 8 to 3. The two female patients had a VAS score reduction from 9 to 2 and 6 to 2, respectively. An improvement of the quality of life and the daily activity level were further achieved and accompanied by a sustained reduction in demand for analgesics. All patients showed a good compliance in handling the neurostimulator.

Conclusions: Peripheral nerve field stimulation is an effective and safe alternative option to relieve chronic pain originating from atypical neuropathic pain syndromes if conservative treatment modalities fail. The preoperative selection plays a crucial role for good results.