Waveform Electrostimulation: Can It Be Another Option For Painful Peripheral Neuropathy?

Raymond Abdo, DPM, and Jaret Walker, DPM

Another approach to counteract DPN is surgical nerve decompression. In Podiatry Today, Barrett discussed the success of decompressing affected nerves.11 Mahoney reported on performing 200 nerve decompression procedures for patients with diabetes and reportedly had an overall success rate of 88 percent.12
However, in a 2003 Podiatry Today roundtable discussion, Boulton denounces surgical decompression for diabetic peripheral sensory motor neuropathy, emphasizing that this type of neuropathy is not an entrapment neuropathy.13 DeHeer points out that the research on surgical decompression has largely been performed by affiliates of the same institute.11

Can Non-Invasive Devices Have An Impact?
Anodyne® (Anodyne Therapy) is one of the first non-invasive devices introduced to the market for the treatment of peripheral neuropathy. This FDA-approved device uses monochromatic infrared light energy (MIRE) to increase circulation and decrease pain. In Leonard’s study, results showed a decrease in pain for patients with DPN.14 Recently, Lavery stated that the study performed by Leonard, et al., lacked statistical quality. Lavery also claims the intent to treat strongly influenced the studies by not showing negative results from the patients involved in the studies.15 Currently, Medicare and other insurances companies do not reimburse for this kind of therapy.
Recently, another device has been introduced into the market. MicroVas® (NeuroVasix) is also a non-invasive, FDA-approved device, which utilizes a magnetic waveform to increase blood flow and oxygenation in the area. A preliminary report conducted by Harkless, et al., revealed a lasting reduction in pain and increased sensation of the lower extremities in a study of 20 patients with diabetes. No statistical analysis has been provided as of yet.16
In the past, physicians have utilized electrostimulation with a biphasic exponentially decaying waveform to treat DPN. One study examined 26 patients who first received amitriptyline to see if symptoms subsided. Twenty-three of the 26 patients who received some relief or did not respond to the medication received electrostimulation or a sham therapy. These patients continued taking amitriptyline. Treatments were self-administered for 30 minutes daily for 12 weeks. Of the 14 control group patients who received dual therapy, 11 showed improvement of their symptoms. However, the patients’ symptoms returned soon after the electrostimulation treatment ceased.17

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