The Role of Peripheral Nerve Stimulation for the Treatment of Neuropathic Pain Following Brachial Plexus Injury: A Scoping Review of Neuromodulation Modalities

A majority of patients with brachial plexus injuries (BPIs) develop neuropathic pain, which is not consistently resolved by medications or surgery. Peripheral nerve stimulation (PNS) shows promise as a supplemental treatment for BPI-associated pain, but comprehensive reviews analyzing its efficacy are limited. Therefore, this study aimed to summarize existing literature on the efficacy of PNS for treating BPI-associated neuropathic pain. A systematic literature search was performed in PubMed, Embase, and Web of Science, querying articles assessing PNS for treatment of neuropathic pain in adults with BPIs. Descriptive statistics and narrative syntheses summarized study characteristics, demographic and clinical data, and pain-related outcomes. Of 409 articles from the initial search, 9 met inclusion criteria. In 8 studies (88.9%), PNS was clinically effective in pain reduction. Of these, 5 (62.5%) used percutaneous electrode placement, 2 (25.0%) used open implantation, and 1 (12.5%) used transcutaneous stimulation. Peripheral nerve stimulation demonstrated pain-reduction capabilities in both preganglionic and postganglionic BPIs. These early findings show promise for PNS for treating refractory pain in patients with limited therapeutic options. Still, PNS for treating BPI-associated pain is an evolving and understudied field. Continued research is needed to better assess its indications, efficacy, and optimal settings to create a personalized pain-management approach.