How PNT Helps with Lower Back Pain (Research Article)

The treatment involves the delivery of electrical stimulation directly to the deeper tissues (muscles, ligaments, tendons) near the spine through several needle electrodes. Careful placement of the needle electrodes is designed to reach the nerve pathways that may be impacting the pain. The theory is that this type of electrical stimulation helps curtail the central nervous system hypersensitivity that leads to persistent pain.

In addition to improved lower back pain relief, early studies have indicated that many patients receiving percutaneous electrical stimulation (such as PNT) reported the following improvements:

  • Increased physical activity
  • Reduced need for pain medications
  • Improved quality of sleep.1,2,3

Treatment Approach to Reduce Lower Back Pain

PNT is designed for treating patients with lower back pain in the physician’s office. A typical PNT therapy session is as follows:

The patient lies face down on an examination table.

  • Once the patient is comfortable, up to 10 PNT electrodes (called "Safeguides”) are applied to the lower back and buttock area at specific locations.
  • Each Safeguide deploys a fine-gauge filament electrode - approximately two-to-three times the size of a human hair - to a depth of three centimeters. For most patients, this insertion causes little or no discomfort
  • After deploying the electrodes, the physician adjusts the electrical stimulation to a level that will deliver therapeutic benefit with minimal discomfort.

The stimulation typically results in a deep tingling or tapping sensation in the area surrounding the electrodes. During the 30-minute session, patients are asked to relax and remain still. After the treatment is done, the electrodes are removed and patients may go home or back to work - there are no activity restrictions for patients after the procedure.

Patients are generally advised to commit to a course of three to four PNT sessions before evaluating the procedure’s effectiveness, as multiple sessions are typically required before a measurable benefit may be experienced.

Some patients may experience some level of pain relief after just a single PNT session, and some may experience little or no pain relief even after several sessions. The most appropriate frequency of treatments and course of therapy tend to vary for each patient.

Patients with complex spinal pathologies often are best served through an integrated pain management approach. Consequently, patients may undergo a course of PNT alone, or in combination with other therapies as part of a multidisciplinary low back pain treatment plan.

PNT Clinical Trial Results

In a recent non-controlled, non-blinded multi-center study, researchers examined the effect and benefit of PNT on a population of low back pain patients with pain radiating into the lower extremities (legs and feet). Patients receiving PNT therapy reported the following overall benefits:

  • Improved pain control
  • Increase activity levels
  • Reduces use of pain medications
  • Enhanced quality of sleep
  • Lower levels of disability.6

Approximately three quarters of patients completing the study said that they would want to receive PNT treatments again if they were to experience another episode of low back pain.6 There was no control group for comparison in this study.

No significant complications or side effects were reported during the study.

As with all new treatments, there are no long-term studies available on the effectiveness, potential risks or complications of PNT. To date, no independent, randomized clinical trials have been performed.


Conclusion on PNT for lower back pain relief

PNT is a new, minimally invasive procedure that has recently been cleared by the FDA. This treatment has been developed for patients who have not achieved enough pain relief through nonsurgical treatments (such as physical therapy, medications, chiropractic or osteopathic treatments) and are considering more invasive and expensive procedures. Early studies indicate that PNT appears to reduce pain and improve activity levels for a wide range of patients with low back pain.


  • 1.Ghoname EA, Craig WF, White PF, et al. Percutaneous Electrical Nerve Stimulation for Low Back Pain: A Randomized Crossover Study. JAMA. 1999
  • 2.Seroussi R, Gliner BE, Steinintz E, Schmitt S, Gamburd R, Firlik AD. Effectiveness of Percutaneous Neuromodulation Therapy (PNT) for Patients with Chronic and Severe Low Back Pain Study. Pending publication.
  • 3.Borg Stein J, Seroussi RG, Schmitt S, et al. Safety and Efficacy of Percutaneous Neuromodulation Therapy in the Management of Subacute Radiating Low Back Pain. Pending publication.