The Effects Of Pulsed Electromagnetic Field Treatment In Pain Due To Diabetic Polyneuropathy

Abstract

Objectives: Diabetic polyneuropathy is the most common and disabled complication of diabetes mellitus. Pharmacological treatment of diabetic neuropathy is limited because of the side efects of the drugs, used in the treatment of diabetic neuropthy. Alternative treatments are also used in diabetic neuropathy. Systemic side effects of non-pharmacological treatment modalities are rare. We evaluated the value of pulsed electromagnetic field treatment in patients with pain due to diabetic polyneuropathy. Patients and Methods:Symptomatic 95 patients were included in the study, and from these patients, 25 patients were randomized in pulsed electromagnetic field treatment group and 25 patients were randomized in placebo group. Pulsed electromagnetic field device was applied over both feet of the patients for one hour a day (during 10 days). Visual analog scale and neuropathic pain scale of all patients were performed before and after treatment and 6th week. Electroneuromyography was also performed before treatment and 6th week.Results: Improvement of pain determined by visual analog scale was 53% after treatment and 67% six weeks later. The improvement of visual analog scale scores were statistically significant in study group when compared with control subjects. Conclusion:The pulsed electromagnetic field may be an alternative treatment modality in diabetic patients with neuropathic pain.

Electrical stimulation and electromagnetic field use in patients with diabetic neuropathy: systematic review and meta-analysis

“…Of the articles comparing electromagnetic field use versus placebo group, one showed no significant improvement in pain relief [-0.69 (95% CI: -1.86 to 0.48; I2: 63%, p=0.25)] ( Figure 2B) [18][19][20][21] .…”

“…Eight studies properly described the generation of a random sequence 13,14,18,19,20,22,23 . No study clearly described allocation concealment.…”

“…The devices used to generate the magnetic fields were different between studies, as one study assessed the exposure to a pulsed electromagnetic field 18 , another study assessed exposure to a static magnetic field 20 , and two studies assessed low-frequency pulsed magnetic exposure 19,21 . Regarding exposure duration, one study performed less exposure 21 , and two studies had shorter total exposure times 18,21 . In addition, two studies had a small number of patients 18,21 .…”

“…As several studies have suggested, nonpharmacological options, such as electrical stimulation, which represents one of the more benign therapies for this condition 9 , may contribute to a better quality of life and fewer complaints of pain 10 . In randomized trials, various types of electrotherapy, such as transcutaneous electric nerve stimulation (TENS) [11][12][13][14][15] , pulsed electromagnetic fields [16][17][18][19] , static magnetic field therapy 20 , low-frequency pulsed magnetic field 21 , high-frequency external muscle stimulation (HF) 22 , frequency-modulated electromagnetic neural stimulation (FREMS) 23 and percutaneous electrical nerve stimulation (PENS) 24 , have been reported to show beneficial effects, such as decreased pain and improved sensitivity, due to electric stimulation in the treatment of patients with PDN.…”

“…However, studies comparing these benefits with those obtained from placebo had small sample sizes and showed conflicting results [11][12][13][14][15][18][19][20][21][22][23][24] . A systematic review of the evidence would allow for a more precise evaluation of its effectiveness and, if the benefits are proven, aid in disseminating the use of electrical stimulation.…”