Expanding Indications: SCS for Painful Diabetic Neuropathy & Visceral Pain

Learning Objectives

As a result of participating in this activity, learners will be better able/better-able to:

• identify patients with refractory painful diabetic neuropathy who are likely to benefit from FDA-approved interventional procedures

Accreditation & Designation

Neurovations Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Neurovations Education designates this live activity for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity includes discussions of unlabeled or investigational uses of commercial and/or developmental products.

This activity includes discussions and explorations of new and evolving topics. Such inclusion includes adequate justifications of statements based upon current science, evidence and clinical reasoning.

Disclosure of Financial Relationships & Measures to Resolve of Conflicts of Interest

Presenter: Taissa Cherry discloses the following financial relationships: Research: Nevro [relationship has ended over 24 months ago], Boston Scientific [relationship has ended over 24 months ago]

No other person with control of, or responsibility for, the planning, delivery, or evaluation of accredited continuing education has, or has had within the past 24 months, financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships have been mitigated. Materials were reviewed in advance of the activity by person(s) that do not have conflicts of interest related to the content. In some cases, content may have been modified as part of the review and mitigation process. All clinical recommendations are evidence-based and free of commercial bias (e.g., peer-reviewed literature, adhering to evidence-based practice guidelines).

Additional Reading

1. Centers for Disease Control and Prevention. National Diabetes Fact Sheet, 2011. 2011.
2. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011; 94:311–321. [PubMed: 22079683]
3. Barrett AM, Lucero MA, Le T, Robinson RL, Dworkin RH, et al. Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review. Pain Med. 2007; 8:S50–62. [PubMed: 17714116]
4. Tesfaye S, Selvarajah D. Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. Diabetes Metab Res Rev. 2012; 28:8–14. [PubMed: 22271716]
5. •5. Morales-Vidal S, Morgan C, McCoyd M, Hornik A. Diabetic peripheral neuropathy and the management of diabetic peripheral neuropathic pain. Postgrad Med. 2012; 124:145–153. [PubMed: 22913903]
6. Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006; 82:95–100. [PubMed: 16461471]
7. Abbott CA, Malik RA, van Ross ER, Kulkarni J, Boulton AJ. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K. Diabetes Care. 2011; 34:2220–2224. [PubMed: 21852677]
8. Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care. 2006; 29:1518–1522. [PubMed: 16801572]
9. Hartemann A, Attal N, Bouhassira D, Dumont I, Gin H, et al. Painful diabetic neuropathy: diagnosis and management. Diabetes Metab. 2011; 37:377–388. [PubMed: 21820345]
10. Ziegler D. Painful diabetic neuropathy: advantage of novel drugs over old drugs? Diabetes Care. 2009; 32:S414–419. [PubMed: 19875591]
11. Kluding PM, Pasnoor M, Singh R, Jernigan S, Farmer K, et al. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complications. 2012; 26:424–429. [PubMed: 22717465]
12. Mendell JR, Sahenk Z. Clinical practice. Painful sensory neuropathy. N Engl J Med. 2003; 348:1243–1255. [PubMed: 12660389]
13. Hovaguimian A, Gibbons CH. Clinical Approach to the Treatment of Painful Diabetic Neuropathy. Ther Adv Endocrinol Metab. 2011; 2:27–38. [PubMed: 21709806]
14. Cheng, J., & Rosenquist, R. W. (Eds.). (2018). Fundamentals of Pain Medicine. Springer International Publishing.
15. Cheng, J. (2021). Is It Time to Redefine Neuropathic Pain?. Pain Medicine, 22(12), 2801-2802.
16. Mekhail, N. A., Cheng, J., Narouze, S., Kapural, L., Mekhail, M. N., & Deer, T. (2010). Clinical applications of neurostimulation: forty years later. Pain Practice, 10(2), 103-112.
17. Mekhail, N. A., Mathews, M., Nageeb, F., Guirguis, M., Mekhail, M. N., & Cheng, J. (2011). Retrospective review of 707 cases of spinal cord stimulation: indications and complications. Pain practice, 11(2), 148-153.
18. Xu, J., Liu, A., & Cheng, J. (2017). New advancements in spinal cord stimulation for chronic pain management. Current Opinion in Anaesthesiology, 30(6), 710-717.
19. Xu, L., Sun, Z., Casserly, E., Nasr, C., Cheng, J., & Xu, J. (2022). Advances in interventional therapies for painful diabetic neuropathy: a systematic review. Anesthesia & Analgesia, 134(6), 1215-1228.
20. Kapural, L., Gupta, M., Paicius, R., Strodtbeck, W., Vorenkamp, K. E., Gilmore, C., ... & Province-Azalde, R. (2020). Treatment of chronic abdominal pain with 10-kHz spinal cord stimulation: safety and efficacy results from a 12-month prospective, multicenter, feasibility study. Clinical and translational gastroenterology, 11(2).