Painful diabetes complication now being treated with established therapy option
Posted: November 10, 2022 | Word Count: 921
Living with diabetes had always been manageable for Kent Apple by eating healthy and remaining active. However, he knew he needed to see his doctor when he started experiencing pain in his legs and feet.
“As a retired construction worker, I noticed the pain the last several years that I was working and thought it was from walking on concrete all day,” said Apple. “The pain felt like an electric shock in my feet and legs.”
He was suffering from painful diabetic peripheral neuropathy (DPN) — a chronic pain condition that affects approximately 30% of diabetes patients.1 High blood sugar levels can damage nerves over time, leading to pain. For some, the pain can become excruciating and negatively impact quality of life.
Those who suffer from DPN often experience chronic numbness, burning or stabbing pain in their legs and feet, making it difficult to walk, stand or even sleep.
There is no cure for DPN, and treatment is directed at slowing the worsening of symptoms, relieving pain and managing complications.
“In my practice, I always ask my patients if they have diabetes or symptoms of DPN because diabetes is a very common medical problem,” said Dr. G. Silky Patel, an interventional spine, sports and pain management physician in Houston, Texas. “When a patient is referred to me for DPN, we start with treatments like gabapentin, compression socks, pain creams and physical therapy, but those don’t always work.”
While mild and moderate cases of DPN can be treated with over-the-counter or prescription medications, some data suggests limited effectiveness. One study showed approximately 77% of patients prescribed an anticonvulsant (pregabalin) for DPN will discontinue the treatment within 1 year because of intolerable side effects or lack of efficacy.2,3 More severe DPN cases may be treated with opioids, which have potentially severe side effects, including addiction and abuse.1
To help treat Apple’s painful DPN, Dr. Patel first recommended gabapentin. While it helped, the relief didn’t last, and Dr. Patel had to increase the dose. Apple found himself back in her office just a few months later, complaining of the side effects of gabapentin. Apple felt he was at a loss until Dr. Patel gave him information on spinal cord stimulation.
Spinal cord stimulation (SCS) is a proven, non-opioid, FDA-approved way to manage chronic pain that is caused by DPN. The technology has been around for about 40 years, and works by disrupting the pain signals traveling between the spinal cord and the brain. Stimulation is delivered via a Medtronic Intellis or Vanta neurostimulator, implanted under the skin. These Medtronic spinal cord stimulators were recently approved by the U.S. Food and Drug Administration for the treatment of pain caused by DPN.
“At first, I was a little hesitant. Being 73, the thought of having something implanted in my body was a little scary,” said Apple. “But now I know what a difference SCS has made for me, and it was no mistake at all.”
Studies show people with painful DPN are 17 times more likely to experience significant pain relief if treated with SCS compared to conventional treatment.4,5,6 Additionally, 86% of patients experienced treatment success after receiving SCS therapy for one year and benefited from meaningful pain relief out to 5 years.7
“I’ve seen how DPN patients have benefitted greatly from SCS implants,” said Dr. Patel. “It’s important that my DPN patients, who have been told that there’s no hope for their pain symptoms, know that there are treatments out there that are proven to effectively provide therapeutic relief.”
SCS can offer proven long-term therapy for managing chronic pain, with the majority of patients experiencing meaningful pain relief through five years of treatment using the device.7
This treatment isn’t made for everyone, and these decisions should be made in consultation with a doctor. Spinal cord stimulation involves risks including infection, lead movement, pain at the implant site and loss of therapy effectiveness. Patients with diabetes may be at higher risk of complications when undergoing surgery. To learn more about spinal cord stimulation for diabetic peripheral neuropathy pain, visit www.medtronic.com/dpnpain.
“Before getting an SCS implant, I was in so much pain that I almost gave up the activities I loved the most,” said Apple. “But now, I have very little pain, and I’m back to daily walks with my dog. I’m much more active now than I was.”
1. Sloan G, Alam, U, Selva rajah D, Tesfaye S. The Treatment of Painful Diabetic Neuropathy. Current Diabetes Reviews. July 2021
2. Staudt MD, et al. Current strategies for the management of painful diabetic neuropathy. Journal of Diabetes Science & Technology. 2020;16(2):341-52.
3. Finnerup NB, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurology. 2015;14(2):162-73.
4. de Vos CC, Meier K, Zaalberg PB, et al. Spinal cord stimulation in patients with painful diabetic neuropathy: a multicentre randomized clinical trial. Pain. 2014 Nov;155(11):2426-31.
5. Medtronic. Medtronic Pain Therapy Clinical Summary M221494A016 Rev B. United States; 2022.
6. Slangen R, Schaper N, Faber C, et al. Spinal Cord Stimulation and Pain Relief in Painful Diabetic Peripheral Neuropathy: A Prospective Two-Center Randomized Controlled Trial. Diabetes Care. 2014;37:3016-3024.
7. Van Beek M, Geurts J, Slangen R, et al. Severity of Neuropathy Is Associated With Long-term Spinal Cord Stimulation Outcome in Painful Diabetic Peripheral Neuropathy: Five-Year Follow-up of a Prospective Two-Center Clinical Trial. Diabetes Care. 2018;41:32–38.