A Help For Diabetic Neuropathy. A New Look At Spinal Stimulation

A large number of Americans suffer with prediabetic or diabetic small fiber neuropathic pain. This number is approximately 75 million Americans. For these Americans, diabetic neuropathy has been very difficult to treat in years passed. Most recently with the development of the use of Cymbalta as well as Lyrica, there has been some benefit. Unfortunately, the patients still continue to suffer with either a lot painful sensations or an unpleasant sensation in their lower extremities.

For the past 20 years, antiseizure medications as well as tricyclic antidepressants have been the gold standard for managing these difficult patients. Also, opiates and/or narcotics have been used with success, however, limited.

A recent study by Francis J. McDonald has demonstrated that spinal stimulation has improved the sensory experience in 85% of the patients. The researchers under Dr. McDonald looked at a three-year period superficial burning, numbness, or skin hypersensitivity. These patients have tried topical creams, injection therapies, as well as oral medications, all of which have failed.

The patients then underwent a trial of spinal stimulation and had an improvement in their pain scores falling from 9.2 to 1.6. Dr. McDonald’s statement is “The real difference here is that 85% of the patients had improvement of sensation.” Not only was pain improved, but more importantly the patients for the first time could truly feel themselves standing on the floor or walking. Often times, patients would have described their sensation of walking on sand or a very soft surface.

Along with the 85% improvement, there was complete reversal of sensory loss that was observed in 58% of these patients. The patients who had spinal stimulation noted increased activities of daily living and a significant reversal of their trophic changes. Due to the fact that the patients had better pain management they significantly reduced their medications by at least a third. The Washington Pain Center has had several patients with diabetic neuropathy that have done exceptionally well with spinal stimulation.

We are pleased to see that other investigators and physicians are using neuromodulations for these difficult patients. Also, the Washington Pain Center is currently undergoing a study for patients with chemotherapeutic-induced peripheral neuropathy. This is the same small nerve neuropathy that is seen in patients with diabetic neuropathy.

Please visit the web site with respect to learning more about spinal stimulation.

-John F. Dombrowski, MD