Percutaneous nerve stimulation belongs to the field of neuromodulation. Neuromodulation interferes at the neurological level and aims to alter nerve activity. Neuromodulation works by either actively stimulating nerves to produce a natural biological response or by applying targeted pharmaceutical agents in tiny doses directly to site of action. Neurostimulation devices involve the application of electrodes to the brain, the spinal cord or peripheral nerves. Percutaneous Nerve Stimulation acts upon peripheral nerves. The most known is PTNS (Percutaneous tibial nerve stimulation). This technique directs at the nervus tibialis posterior and alters nerve activity in the pelvis via the plexus sacralis.Technique
The discipline of PNS is closely related to the field of neuromodulation in which devices are implanted to elicit electrical impulses to a specific nerve.
In certain conditions interventions have developed while using a percutaneous needle.
Read all about the recommendations and research on PTNS
Percutaneous Tibial Nerve Stimulation
The electrostimulation is offered in 12 weekly sessions of 30 min. A 34-gauge stainless steel needle is inserted approximately 3–4 cm about 3 fingerbreadths cephalad to the medial malleolus, between the posterior margin of the tibia and soleus muscle. A stick on electrode is placed on the same leg near the arch of the foot. The needle and electrode are connected to a low voltage (9 volts) stimulator* with an adjustable pulse intensity of 0–10 mA, a fixed pulse width of 200 microseconds and a frequency of 20 Hz. The amplitude is slowly increased until the large toe starts to curl or toes start to fan. If the large toe does not curl or pain occurs near the insertion site the stimulation device is switched off and the procedure is repeated. If the large toe curls or toes start to fan stimulation is applied at an intensity well tolerated by the patient. If necessary, the amplitude can be increased during the session.
– Pacemakers or implantable defibrillators.
– Patients prone to excessive bleeding.
– Patients with nerve damage that could impact either PTNS or pelvic floor function.
– Patients who are pregnant or planning to become pregnant during the duration of the treatment.
Risks: low. Most common side-effects are temporary and include mild pain or skin inflammation at or near the stimulation site.
For more details you can take a look hereNeedles
A specific needle is prescribed in PTNS.
Diameter: 0,34 mm