Thanks to researchers at the University of Twente, patients suffering from diabetic neuropathy can now benefit from a new treatment : spinal cord stimulation. Diabetic neuropathy, a frequent complication of diabetes mellitus, seriously affects the quality of life of patients and does not respond to common analgesics. Cecile de Vos, PhD student at the University of Twente and the medical physicist working at Medisch Spectrum Twente Hospital, noted that this new method is promising for patients with diabetes.
Statistics show that in the Netherlands about one million people suffer from diabetes and 15% of them have diabetic neuropathy, that is chronic pain. Diabetic neuropathy, the most common complication of diabetes, is described by patients as a stinging or burning pain. There are several mechanisms that cause diabetic neuropathy: chronic hyperglycemia, poor circulation of blood in peripheral tissues, growth factors deficit, etc.
Diabetic neuropaty usually occurs in the legs and is manifested throughout the day but especially in the evening and at night. There are several classes of drugs for pain : analgesics, NSAIDs, anticonvulsants, but usually this pain is resistant to treatment. De Vos said that spinal cord stimulation may relieve pain in patients with diabetic neuropathy. Studies have shown that the new therapy decreases pain intensity from an average of 8 to 2 and that pain is now manageable. De Vos added that spinal cord stimulation significantly improves the quality of life of patients with diabetic neuropathy; they can now return to their normal daily activities.
Spinal cord stimulation reduces pain by stimulating with electrical impulses the spinal nerves. The system is similar to a pacemaker as it involves implanting a stimulation electrode in the epidural space. Stimulation of spinal nerves causes the pain signals (that are transmitted from the leg) be felt less or not at all. De Vos noted that spinal cord stimulation is a therapy used in the Netherlands for many years to relieve pain in patients who underwent back surgery, but it was never used to treat pain from diabetes.
Patients enrolled in the study were divided into two groups: a group of patients who received spinal cord stimulation and a control group that received medical treatment. Patients with spinal cord stimulation had less pain after one month: pain intensity decreased from an average of 8 to 2, compared with those who received medical treatment and who had no decrease in pain intensity. Moreover, it seems that the effect of spinal cord stimulation is a long term effect as pain relief was maintained for 6 months.
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