If you have diabetes, you no doubt already know that as many as 50% of diabetic patients suffer the serious complication of diabetic neuropathy. Those with painful diabetic neuropathy can experience conditions that range from tingling or numbness to a burning, excruciating, stabbing or intractable type of pain.
The first step that your diabetes medical specialist will usually focus on is tight glycemic control to manage this condition – using diet, oral medications, or insulin to control blood sugar levels (glucose). They’ll also regularly screen for associated complications. However, providing relief from the pain is a different issue that can be challenging and complicated.
Several prescription drugs are FDA approved for diabetes-related nerve pain, but they don’t work for everyone. Fortunately for those suffering, the Food and Drug Administration (FDA) has approved the use of non-drug, high-frequency spinal cord stimulation (SCS) as an alternative treatment.
Treating Painful Diabetic Neuropathy with Spinal Cord Stimulation
Estimates are that there are 2.3 million individuals in the United States whose diabetic neuropathy pain symptoms aren’t manageable with medications. With the FDA approval of spinal cord stimulation for this condition, this untreatable group now has a new potential alternative.
Treatment involves the minimally invasive epidural implantation of a 10 kHz, high frequency spinal cord stimulator device – which delivers mild electrical impulses to the nerves to interrupt pain signals to the brain.
Spinal Cord Stimulation is a well refined therapy which has been in used since 1967, and has grown exponentially with major developments in the 50+ years since. However, the FDA’s announcement represents the first approval of this treatment specifically for diabetic neuropathy pain.
Reducing Potential Drug Interaction Complications
Diabetic neuropathy pain is notoriously difficult to treat. The Mayo Clinic notes that pain-relieving treatments may include anti-seizure drugs such as pregabalin (Lyrica) and Gabapentin (Gralise, Horizant, Neurontin), or antidepressants (to ease nerve pain, even if you aren’t depressed), including tricyclic antidepressants.
Sometimes these two drug classes can be combined. These drugs can also be used along with over-the-counter medications – of course, but only with your doctor’s involvement and recommendations.
The problem is that this drug approach can require a significant amount of medications daily to achieve a meaningful reduction in pain. Coupled with the spectrum of potential side effects, and the need to manage drug-drug interactions, leads to an understanding of why the potential of spinal cord stimulation as an effective non-drug approach, for some, is so compelling.
A Note of Caution
The FDA’s approval is based in part on successful clinical trials, including a 6-month trial published last April in JAMA Neurology by 37 participating physicians and researchers. While this approach is promising, as in all treatments, it is only appropriate for some candidates.