Diabetic Painful Neuropathy: Treatable with Acupuncture?
In my practice, I receive quite a good number of referrals from other healthcare workers about the treatment of diabetic neuropathy. Diabetes is related to poor peripheral circulation, and thus there is a detrimental effect on the nerves of the parts farthest from the heart – the hands and feet. In addition, such compromised nerves also lead to uncomfortable situations and pain as well.
A recently published study in the journal Acupuncture in Medicine elaborates how Garrow, et al worked out a way to test if acupuncture can help. 45 patients were allocated to receive a 10 week course of either real or sham acupuncture. The study says that five acupuncture points were used. These were Liver 3 Taichong, Spleen 6 Sanyinjiao, Spleen 10 Xuehai, Stomach 36 Zusanli and Kidney 3 Taixi. Outcome measures were studied using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale, lower limb pain (Visual Analogue Scale, VAS); Sleep Problem Scale (SPS); Measure Yourself Medical Outcome Profile (MYMOP); 36-item Short Form 36 Health Survey and resting blood pressure (BP).
The study clearly showed that there was a significant difference in those who received real, penetrative acupuncture on the points mentioned as opposed to those who received sham. To be precise:
Over the 10-week treatment period, small improvements were seen in VAS -15 (-26 to -3.5), MYMOP -0.89 (-1.4 to -0.3), SPS -2.5 (-4.2 to -0.82) and resting diastolic BP -5.2 (-10.4 to -0.14) in the true acupuncture group. In contrast, there was little change in those receiving sham acupuncture. A moderate treatment effect in favour of active acupuncture was detected in MYMOP scores -0.66 (-0.96 to -0.35) but non-significant effect sizes in LANSS Pain Scale -0.37 (-2.2 to 1.4), resting diastolic BP -0.50 (-3.0 to 1.99) and the SPS -0.51 (-2.2 to 1.16).
And the researchers concluded:
We have demonstrated the practicality and feasibility of acupuncture as an additional treatment for people with DPN. The treatment was well tolerated with no appreciable side effects. Larger randomised trials are needed to confirm the clinical and cost-effectiveness of acupuncture in the treatment of DPN.
Garrow, et al. (2014) Role of acupuncture in the management of diabetic painful neuropathy (DPN): a pilot RCT. Acupunct Med. 2014 Mar 21 PMID 24657491