The American Academy of Physical Medicine and Rehabilitation (AAPM&R), in collaboration with the American Association of Neuromuscular and Electro-diagnostic Medicine and the American Academy of Neurology, has released a new guideline on the most effective treatments for diabetic nerve pain, the burning or tingling pain in the hands and feet that affects millions of people with diabetes. It will be published in the April issue of the AAPM&R scientific journal PM&R.
“The Evidence Based Guideline: Treatment of Painful Diabetic Neuropathy” will appear in the scientific journals of all three organizations—PM&R, Muscle and Nerve, and Neurology. Diabetic nerve pain, or neuropathy, is caused by nerve damage and presents ongoing management problems for patients, caregivers, and physicians. It often goes unreported by patients.
Thiru M. Annaswamy, MD, associate professor in the department of PM&R, UTSWMC Dallas and co-author of the guideline said, “Painful diabetic neuropathy (PDN) is a very common condition that most physiatrists encounter in their clinical practice. This guideline is very helpful in evaluating the evidence basis behind the use of several medications and non-pharmaceutical agents that are available for use in the management of PDN. While it is heartening to see the high levels of evidence supporting the use of the some of the treatments in alleviating pain, it also underscores the need for more research that needs to be done in this area to better understand how these treatments can improve the function, reduce disability and need for assistance, as well as reduce overall cost of care of a patient suffering from this chronic condition.”
According to the guideline, strong evidence shows the seizure drug pregabalin is effective in treating diabetic nerve pain and can improve quality of life; however, doctors should determine if it is appropriate for their patients on a case-by-case basis.
In addition, the guideline found that several other treatments are probably effective and should be considered, including the seizure drugs gabapentin and valproate, antidepressants such as venlafaxine, duloxetine and amitriptyline and painkillers such as opioids and capsaicin. Transcutaneous electric nerve stimulation, a widely used pain therapy involving a portable device, was also found to be probably effective for treating diabetic nerve pain.
# # #
AAPM&R is the national medical specialty society of more than 8,000 physical medicine and rehabilitation physicians, also called physiatrists. Rehabilitation physicians are nerve, muscle, brain and bone experts who treat injuries or illnesses that affect how you move.