Diabetic neuropathy in the lower extremities is a serious, and often disabling, condition for many patients with diabetes. The pain from the neuropathy is often accompanied by numbness, burning, tingling, and cold sensations. It can affect a patient’s sleep as well as ability to safely ambulate. A new study gives hope that high frequency spinal stimulation helps diabetic neuropathy.

Diabetic patients with this condition are usually treated with drugs. However, medical management alone has proven to be unsatisfactory. In one study, only 5% of patients responded favorably to the medical treatment, and only 1% achieved pain remission.

A recent study involved an implantable spinal cord stimulation device. The study, conducted at the University of Arkansas for Medical Sciences in Little Rock, was hailed as “the largest randomized controlled trial evaluating spinal cord stimulation for refractory painful diabetic neuropathy.”

The study utilized high frequency (10 kHz) spinal cord stimulation plus conventional medical management. The participants had a 76% reduction in pain over six months. Overall, more than 85% of the patients were considered responders to this treatment. In addition to the improvement in pain control, other neurological functions also improved: lower limb motor strength, light touch sensation, and reflex testing of the patellar, Achilles, and Babinski reflexes. 

The implantation of the stimulator device was in the low back, with percutaneous leads placed epidurally along T8 to T11. Complications from the implantation of the spinal cord stimulator were relatively small: three infections, two of which required explantation. 

The use of this type of spinal cord stimulation is expensive, but it could mean a major change in how diabetics with neuropathy can function and could, in the long run, result in lower costs associated with medical management of their leg and foot pain. Further research and trials will help to identify the right patients for this therapy.