Abstract
INTRODUCTION: Chronic pain affects millions worldwide, with 15% to 25% being neuropathic due to conditions like diabetic neuropathy and radiculopathy. Neuropathic pain, often described as burning or shooting, includes symptoms like allodynia, significantly impacting the quality of life and posing high economic costs. While pharmacological treatments are common, many patients require more invasive, costly interventions such as spinal cord stimulation. As an alternative, percutaneous electrical nerve stimulation (PENS) therapy (PT) offers a less invasive, cost-effective approach that can be administered outpatient, reducing hospitalization costs and providing psychological benefits like anxiety and stress relief. AIM: This study aimed to compare the efficacy of PT in the short, medium, and long term in patients affected by chronic neuropathic pain, resistant to conventional pharmacological therapies, using a single active PT probe. METHODS: A total of 100 patients were enrolled for the first PT procedure, and 190 procedures were performed from 2021 to 2023. Excluding those for whom pain could not be detected during follow-up, 41 patients were enrolled, to whom only one PT procedure was performed (Group I). Fourteen patients were enrolled, to whom two PT treatments were performed (Group II), and finally, eight patients were enrolled, to whom three or more PT treatments were performed (Group III). Therefore, a total of 63 patients were enrolled, and 106 PT procedures were performed with pain detected according to the Numeric Pain Scale (NRS) during the entire follow-up period. All patients who presented a trigger point and a specific nevus path or who presented a specific allodynic area caused by a surgical scar were treated. RESULTS: The group of patients who showed a greater decrease in pain from T0 (baseline) to T1 (three hours after PT) were those who underwent two PT sessions (-52.7%, p = .001). The greatest percentage decrease between before the procedure and seven days after the PT was obtained in the group of patients who underwent three or more PT sessions (T0 4.9 vs. T2 2.9, -40.8%, p < .001). The same group of patients also showed the greatest decrease in pain four weeks after the PT (T0 4.9 vs. T3 3.1, -36.7%, p < .001). CONCLUSION: PT appears to be an alternative therapy to pharmacological and infiltrative therapy against chronic neuropathic pain.