Diabetic Neuropathy: High-Frequency Spinal Cord Stimulation Offers Pain Relief

PainRelief.com Interview with:
Erika A. Petersen, MD, FAANS, FACS
Professor of Neurosurgery
Residency Program Director
UAMS Department of Neurosurgery

PainRelief.com: What is the background for this study?

Response: Painful diabetic neuropathy is a common occurrence for patients with diabetes and can have a tremendous negative impact on their quality of life. Currently, the best available treatments include several types of medications and topical solutions, but there are many patients who do not achieve adequate pain relief or cannot tolerate side effects from these treatments. We need new options for patients who have tried the recommended first- and second-line treatments but still suffer with severe pain.

PainRelief.com: What are the main findings?

Response Our publication reports the results from a prospective, multicenter, randomized controlled trial comparing conventional medical management (CMM) alone to the addition of high-frequency (10 kHz) spinal cord stimulation (SCS) to CMM. Over the course of 6 months, patients in the CMM group saw no change in their pain scores whereas those in the 10 kHz SCS group experienced a 76% reduction in pain on average. In addition, 85% of patients in the 10 kHz SCS group were treatment responders (defined as those with at least 50% pain relief) compared to 5% of patients in the CMM group. Additional benefits of 10 kHz SCS were demonstrated by improvements in sleep, health-related quality of life, and neurological function.

PainRelief.com: What should readers take away from your report?

Response: I’m hopeful that physicians involved in the care of patients with painful diabetic neuropathy will consider 10 kHz SCS as a treatment option for their patients with refractory symptoms. Our study has shown this therapy to be safe and highly effective for pain control. This is a large patient population with significant unmet needs.

PainRelief.com: What recommendations do you have for future research as a result of this study?

Response: A majority of patients treated with 10 kHz SCS in the study were observed to have improvements in neurological function, including better sensation in their feet. This finding could be of great benefit to patients who are at risk of injury due to numbness in their feet. We need to see if this improvement persists over the full 2-year study follow-up. Additionally, future studies will be needed to better understand how this improvement occurs. 

Any disclosures? This study was funded by Nevro. This important research wouldn’t be possible without the collaboration of my co-investigators and the patients who participated in the study.

Citation:

Petersen EA, Stauss TG, Scowcroft JA, et al. Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy: A Randomized Clinical Trial. JAMA Neurol. Published online April 05, 2021. doi:10.1001/jamaneurol.2021.0538

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