Painful Diabetic Neuropathy

Peripheral neuropathy is a common complication of diabetes mellitus that is often associated with chronic pain. Painful diabetic neuropathy (PDN) is a complex condition with several proposed mechanisms involving metabolic disruption, non-enzymatic glycation, formation of reactive oxygen species, and vascular insufficiency. The clinical features of PDN are variable, thus, proper diagnosis depends on a focused medical history and a comprehensive physical exam. There are five FDA approved treatments for PDN, including three oral agents, one topical, and one surgical intervention. Spinal cord stimulation (SCS) is the most recent therapy for PDN and has shown success in numerous clinical trials.