Treatment of Painful Diabetic Neuropathy—A Narrative Review of Pharmacological and Interventional Approaches

Biomedicines

NebojsaNick Knezevic¹  Alaa Abd-Elsayed²  Bhavika Chowdhury³  Kiran Patel⁴  Mahoua Ray⁵  Mayank Gupta⁵ 

[1] Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA;Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53715, USA;Department of Endocrinology, Saint Luke’s South Hospital, Overland Park, KS 66213, USA;Department of Pain Management, Spine and Pain Institute of New York, New York, NY 10065, USA;Kansas Pain Management & Neuroscience Research Center, Overland Park, KS 66201, USA;

关键词: painful diabetic neuropathy;    diabetes;    neuropathic pain;    peripheral diabetic neuropathy;    neuromodulation;    10 kHz SCS;   

DOI  :  10.3390/biomedicines9050573

来源: DOAJ

【 摘 要 】

Painful diabetic neuropathy (PDN) is a common complication of diabetes mellitus that is associated with a significant decline in quality of life. Like other painful neuropathic conditions, PDN is difficult to manage clinically, and a variety of pharmacological and non-pharmacological options are available for this condition. Recommended pharmacotherapies include anticonvulsive agents, antidepressant drugs, and topical capsaicin; and tapentadol, which combines opioid agonism and norepinephrine reuptake inhibition, has also recently been approved for use. Additionally, several neuromodulation therapies have been successfully used for pain relief in PDN, including intrathecal therapy, transcutaneous electrical nerve stimulation (TENS), and spinal cord stimulation (SCS). Recently, 10 kHz SCS has been shown to provide clinically meaningful pain relief for patients refractory to conventional medical management, with a subset of patients demonstrating improvement in neurological function. This literature review is intended to discuss the dosage and prospective data associated with pain management therapies for PDN.

【 授权许可】

Unknown