Techniques are provided for use with a trial neurostimulation device having a lead for implant within a patient. In one example, neurostimulation is delivered using the lead while an indication of patient pain is detected. Various functions of the trial device are then controlled in response to patient pain, such as by adjusting neurostimulation control parameters to improve pain reduction, recording diagnostic information representative of patient pain or transmitting such parameters to a separate external instrument for analysis. In this manner, patient pain is automatically detected to provide objective feedback as to the efficacy of trial neurostimulation. Various embodiments of flexible trial neurostimulation device patches are described herein, including patches that are adhesively mounted over the point of entry of the trial lead into the patient, thus providing a comfortable patch that hygienically isolates the point of entry of the lead.