Diabetic Peripheral Neuropathy: Amelioration of Pain With Transcutaneous Electrostimulation

  1. Howard J Marshall, DPM
  1. Division of Endocrinology, Department of Medicine, Diabetes and Hypertension, Los Angeles County University of Southern California Medical Center Los Angeles, California
  2. Podiatry Department, Los Angeles County University of Southern California Medical Center Los Angeles, California
  1. Address correspondence and reprint requests to Dinesh Kumar, MD, Box 393, LAC-USC Medical Center, Los Angeles, CA 90033.

Abstract

OBJECTIVE To evaluate the efficacy of transcutaneous electrotherapy for chronic painful peripheral neuropathy in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS Thirty-one patients with symptoms and signs of peripheral neuropathy were randomized to the electrotherapy or sham treatment (control) group. The electrostimulation was given by a portable unit (H-Wave machine) than generated a biphasic, exponentially decaying waveform (pulse width 4 ms, 25–35 V, ≥ 2 Hz). Patients treated each of their lower extremities for 30 min daily for 4 weeks at home. Nine patients from the sham-treatment group participated for a second period, during which all of them received the active electrotherapy. Patient's degree of pain and discomfort was graded on a scale of 0 to 5.

RESULTS In the sham-treated group (n = 13), the neuropathic symptoms improved in five (38%) patients, and the pain score declined from 2.92 ± 0.13 to 2.38 ± 0.26 (P < 0.04), suggesting a procedure-related placebo effect. In the electrotherapy group (n = 18), symptomatic improvement was seen in 15 (83%) cases, 3 of which were completely asymptomatic; the pain score declined from 3.17 ± 0.12 to 1.44 ± 0.25 (P < 0.01) and the posttreatment pain scores were considerably lower (P < 0.03), indicating a substantial treatment effect over and above any placebo influence. Patients in the electrotherapy group reported greater reduction in symptoms (52 ± 7% vs. 27 ± 10% in control subjects, P < 0.05) on an analog scale. Moreover, the electrotherapy decreased pain scores (from 3.0 ± 0.62 to 1.56 ± 0.32, P < 0.02) in nine patients who had received sham treatment earlier.

CONCLUSIONS A form of transcutaneous electrotherapy ameliorated the pain and discomfort associated with peripheral neuropathy. This novel modality offers a potential non-pharmacological treatment option.

  • Received February 7, 1997.
  • Accepted July 11, 1997.
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