The Health series is presented by AdventHealth
Diabetes is a chronic condition that occurs when your blood sugar (glucose) is too high. Either the pancreas stops producing insulin or the body cannot use the insulin it produces. Too much blood glucose and you could develop heart disease, vision problems, and nerve damage.
Diabetic peripheral neuropathy (DPN) is a common complication associated with diabetes. Nerve damage can lead to symptoms such as burning, tingling, and numbness, which can be painful to the feet and hands. These symptoms are often difficult to treat even with tight glucose control. Other undesired consequences include poor wound healing and poor sleep.
Conventional treatment for DPN involves nerve medications, opioids, or topical creams that can have many unwanted side effects. These limited treatment options sometimes leave patients feeling hopeless in finding pain relief.
Now, there is a promising new treatment option: spinal cord stimulation.
Haley Wardrip, MD, pain medicine physician and anesthesiologist with AdventHealth Pain Specialists, shares how this new approach is helping Kansas City patients find relief from DPN issues.
What is Spinal Cord Stimulation?
Spinal cord stimulation (SCS) is a new, non-medication therapy approved for the treatment of chronic pain including diabetic peripheral neuropathy. An easy way to think about it is like a pacemaker for pain. The system consists of a small battery connected to two thin electrical leads that are placed close to the nerves in the epidural space, and there is a small amount of electricity delivered, which helps interrupt the pain signals traveling from the spinal cord and nerves to the brain. This, in turn, provides pain relief that is patient-controlled via a handheld device. With more pain control, patients are free to do the activities they love without being tied down or reliant on medications.
How does SCS work?
This therapy involves a two-step process, starting with a seven-day trial followed by an outpatient procedure for permanent implant. The trial is a “try before you buy” step where, in a clinic setting, a physician places temporary leads and attaches them to an external battery that is taped to the skin. This allows patients to see if SCS works for them and relieves their pain.
If the patient obtains at least 70 percent pain relief during the trial, the next step is proceeding with permanent placement of the SCS device, which consists of a battery connected to electrical leads. This procedure is done in a short outpatient visit. Most SCS devices are MRI compatible, and come as either chargeable or nonchargeable options, with the battery needing replacement every five to ten years.
How effective is SCS for DPN?
The treatment of DPN with spinal cord stimulation has been proven to reduce pain scores as well as improve health-related quality of life. Additionally, some patients report improved sensation to their previously numb area, such as the bottom of the feet. Improved sensation and reduced pain can allow patients to live more active lifestyles. Many patients successfully treated with SCS can reduce their nerve medications and some even come off of them completely. Most DPN patients have been on nerve medications for years and their symptoms have gone unnoticed due to chronicity, but we want these patients to know that there is a treatment option for them, and we can help.
Is SCS covered by insurance?
Spinal cord stimulation is approved by most private insurance companies as well as Medicare for the treatment of diabetic peripheral neuropathy.
How do I get started with SCS?
Talk with your primary provider or whomever manages your diabetes. This may be a PCP, endocrinologist, or podiatrist. From there, you will need a referral to a pain management clinic such as ours, where we will consult with you and discuss your symptoms to see if you are a good candidate for SCS. The patient who will best see relief from this procedure is someone who experiences the symptoms of tingling, burning, and numbness and who has hemoglobin A1c under 10.