Contemporary insights into painful diabetic neuropathy and treatment with spinal cord stimulation

Kai McGreevy, Kayode A. Williams

Research output: Contribution to journalReview article

Abstract

A substantial body of literature is available on the natural history of diabetes, but much less is understood of the natural history of painful diabetic peripheral neuropathy (PDPN), a pervasive and costly complication of diabetes mellitus. Multiple mechanisms have been proposed, including polyol pathway activation, advanced glycosylation end-product formation, and vasculopathic changes. Nevertheless, specific treatment modalities addressing these basic issues are still lacking. The mainstay of treatment includes pharmacological management with antidepressants, anticonvulsants, and opioids, but these drugs are often limited by unfavorable side-effect profiles. For over 30 years, spinal cord stimulation (SCS) has been used extensively for the management of various chronic neuropathic pain states. In the past decade, interest in the use of SCS for treatment of PDPN has increased. This article reviews pathophysiological mechanisms of PDPN, proposed mechanisms of SCS, and the role of SCS for the treatment of PDPN.

Original languageEnglish (US)
Pages (from-to)43-49
Number of pages7
JournalCurrent pain and headache reports
Volume16
Issue number1
DOIs
StatePublished - Feb 1 2012

Keywords

  • Anesthetic techniques
  • Diabetes
  • Diabetic neuropathy
  • Pain management
  • Spinal cord stimulation

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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