Surgical Treatment Shows Promise for Diabetic Neuropathy Relief

Diabetic Neuropathy Relief
Diabetic Neuropathy Relief. Credit | Shutterstock

United States: A surgical treatment being used for the treatment of problems like carpal tunnel syndrome and back sciatica might as well be able to relieve the patients with diabetic neuropathy and is being done according to a recent study.

The pain of those who first received surgical nerve decompression decreased considerably, but up to five years later, only a small group of patients with diabetic neuropathy reported sustained relief, as scientists discovered, as reported by The HealthDay.

The elastic tissue compressing the swollen nerves in the ankle and leg areas was ablated during the surgery. This almost ensures that the blood flow to the trapped nerve will also get back to normal.

Study Reveals Long-Term Impact

Vice-chair of plastic surgery at UT Southwestern Medical Center in Dallas and principal researcher Dr. Shai Rozen said, “The five-year results suggest that the procedure actually does have a positive long-term impact on pain.”

Diabetic neuropathy is estimated to affect about 20 million Americans, a condition where the nerve fibers become irritable and painful due to inconsistencies in the levels of blood sugar, which characterize diabetes.

Symptoms can include pain, muscle weakness, numbness and tingling, burning, and unusually high sensitivity to touch. This state usually focuses on the lower part of the person’s legs.

Diabetic neuropathy can be debilitating, leading to a lack of mobility and a severe reduction in quality of life,” Rozen said in a medical center news release.

“It’s believed that roughly one-third of those with neuropathy pain have nerve compression — where there is direct and chronic pressure on a peripheral nerve — due to physiological changes brought on by diabetes,” Rozen added. “Our research suggests that nerve decompression surgery to release compressed nerves from surrounding tissue could offer lasting relief for those individuals.”

Procedure Details and Trial Results

The clinical trial involved 78 patients randomly divided into two groups- the nerve decompression and medication-only groups.

Patients in the group who had the decompression surgery only had nerves on one leg affected. However, the other randomly selected leg had a “sham surgery” where the surgeon made an incision to imitate the procedure but didn’t remove any tissue.

At the one-year follow-up, the group that underwent surgery experienced substantial pain relief in both legs, while medication patients had scores equal to their baseline values.

“The one-year reports of pain improvement in both legs could mean that there is a placebo effect taking place” that soon after surgery, Rozen said.

Placebo Effect and Long-Term Relief

By year five, the surgical group saw a percent higher pain reduction compared to the placebo group. A bigger improvement was seen in the real surgery leg than in the placebo surgery leg. At that moment, the pain of recipients of the sham treatments was actually more severe than that of the control group, as reported by The HealthDay.

More recently, in the Annals of Surgery, the evidence was being released.

“There is still much debate in the medical community about the value of decompression surgery in treating diabetic neuropathy, and while this study doesn’t settle the issue, it should help expand the discourse among stakeholders and hopefully lead to even more research,” Rozen said. “The goal is to better understand the efficacy of nerve decompression surgery on diabetic neuropathy and improve our ability to identify patients who are likely to respond to surgical intervention.”