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• Posted March 22, 2024

Nerve Treatment Could Help Ease Diabetic Neuropathy

A surgical treatment used to treat conditions like carpal tunnel syndrome and back sciatica might also help relieve the pain of patients with diabetic neuropathy, a new study finds.

Surgical nerve decompression significantly eased pain among a small group of people with diabetic neuropathy for up to five years, researchers report.

In the surgery, researchers removed inflexible tissue that was putting pressure on swollen nerves in the feet and legs. That allows improved blood flow to the nerve, giving it a chance to shrink back to normal size.

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

About 20 million Americans suffer from diabetic neuropathy, in which the fluctuating blood sugar levels of diabetes cause nerves to become irritated and painful.

Symptoms can include pain, muscle weakness, numbness, tingling or burning, and extreme sensitivity to touch. The condition most often affects a person's lower extremities.

“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.”

In the clinical trial, 78 patients were randomly assigned to either undergo nerve decompression or to remain on medication only.

Patients who underwent the surgery only had one leg treated with nerve decompression. The other randomly chosen leg underwent a “sham surgery,” in which the surgeon made incisions to mimic the procedure but didn't remove any tissue.

At the 12-month visit, surgery patients reported significantly less pain in both legs, while those on medication had unchanged pain rankings.

“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.

Buy by five years out, the surgical group reported even greater pain reduction, including far more improvement in the leg that received the actual surgery than in the sham surgery leg. The control group had even worse pain by that point.

The findings were published recently in the Annals of Surgery.

“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."

More information

The Mayo Clinic has more on diabetic neuropathy.

SOURCE: UT Southwestern Medical Center, news release, March 20, 2024