Electrical stimulation therapy through stocking electrodes for painful diabetic neuropathy: a double blind,...

Peripheral neuropathy affects more than a third of diabetic patients, of whom a significant minority will have disabling symptoms. The aim of this study was to assess the efficacy of pulsed-dose electrical stimulation (through stocking electrodes) in the treatment of painful diabetic neuropathy.

Thirty patients with painful diabetic neuropathy were consecutively randomised to wear silver-plated nylon-dacron stocking electrodes for 8 h a night for 6 weeks (pulsed electric current of 50 micro amps delivered by a microcomputer). The control, identical stockings received an insignificant current (5 micro amps). Pre-treatment, weekly and end-of-treatment pain and sleep disturbance scores were recorded.

Fourteen patients completed the study (the 16 non-completers withdrew during the first phase). Mean (+/- sd) age: 57.5 +/- 10.5 years; HbA(1c): 8.3 +/- 1.4%; median (IQR) duration of diabetes: 14.5 (7.6-19.3) years; duration of neuropathy: 4 (3-7) years. Active treatment and control produced similar reductions in pain scores [median (IQR): 40.1 (4.7-97.7)% vs. 49.2 (0.2-91.1)%, P = 0.70] and sleep disturbance scores [median (IQR): 31.1 (-4.6 to 85.4)% vs. 42.6 (-16.2 to 91.1)%, P = 0.70]. Non-completers (seven on active treatment, nine on control) withdrew for similar reasons (inconvenience, exacerbation of symptoms, dermatitis).

There is no evidence from these results that this treatment is more effective than control in the treatment of painful diabetic neuropathy.