Percutaneous Electrical Nerve Stimulation for Facial Pain.

Percutaneous electrical nerve stimulation (PENS) is a novel, minimally invasive and useful treatment modality. Its use in complex facial pain has been on the rise, and its utility will further increase with the advances in the technology and renewed interest in the field of peripheral neuromodulation. PENS therapy can be used both as diagnostic and therapeutic option. The precise mechanism of action is not known, although a combination of electrical neuromodulation and release of endogenous morphine-like substance in the central nervous system appears as plausible explanation. We analyse the various studies in the literature and discuss the Southampton data regarding facial pain treatment with PENS therapy. We believe that PENS therapy for facial pain and headache is currently underutilised. It is safe, economical and should certainly be part of the armamentarium in the treatment of complex facial pain and headache.