Spinal Cord Stimulation Eases Pain and Improves Sensation in People with Diabetic Nerve Damage

A multicenter randomized clinical trial led by the Pain Outcomes Lab at Wake Forest University School of Medicine found that high-frequency spinal cord stimulation significantly reduced pain and improved sensory function in adults with treatment-resistant painful diabetic neuropathy. The study evaluated 10-kHz spinal cord stimulation, a surgically implanted system that sends mild electrical pulses near the spinal cord to change how pain signals travel to the brain, without the tingling sensation associated with some older systems.

The trial enrolled 91 adults with diabetes and chronic painful diabetic neuropathy at 13 U.S. centers. Participants received either conventional medical management alone or spinal cord stimulation plus conventional care. At six months, 79.4% of participants who underwent temporary stimulation had at least a 50% reduction in lower-limb pain, compared with 4% in the conventional-care group. Among those who received a permanent implant and completed follow-up, 93.1% reached that pain-reduction threshold. The study also reported meaningful improvements in touch, temperature, vibration and body-position sensation in 55.2% of stimulation recipients versus 25% of those receiving conventional care.

This matters because diabetic neuropathy can cause pain, numbness, balance problems, ulcers and higher amputation risk, while many existing therapies mainly manage symptoms. The study also found a 56% average increase in small nerve-fiber density in lower-calf skin biopsies among stimulation recipients, though researchers stressed that the trial was not designed to prove nerve regeneration or disease modification. The work was funded by Nevro Corp., the device manufacturer, and the authors noted limitations including lack of participant blinding, early trial stopping, and applicability mainly to severe treatment-resistant neuropathy.