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The Effects of Pulsed Electromagnetic Field Treatment in Pain Due to Diabetic Polyneuropathy

Year 2010, Volume: 2010 Issue: 4, 227 - 233, 01.04.2010
https://doi.org/10.5174/tutfd.2009.01556.2

Abstract

Objectives: Diabetic polyneuropathy is the most common and disabled complication of diabetes mellitus. Pharmacological treatment of diabetic neuropathy is limited because of the side efects of the drugs, used in the treatment of diabetic neuropthy. Alternative treatments are also used in diabetic neuropathy. Systemic side effects of non-pharmacological treatment modalities are rare. We evaluated the value of pulsed electromagnetic field treatment in patients with pain due to diabetic polyneuropathy. Patients and Methods: Symptomatic 95 patients were included in the study, and from these patients, 25 patients were randomized in pulsed electromagnetic field treatment group and 25 patients were randomized in placebo group. Pulsed electromagnetic field device was applied over both feet of the patients for one hour a day (during 10 days). Visual analog scale and neuropathic pain scale of all patients were performed before and after treatment and 6th week. Electroneuromyography was also performed before treatment and 6th week. Results: Improvement of pain determined by visual analog scale was 53% after treatment and 67% six weeks later. The improvement of visual analog scale scores were statistically significant in study group when compared with control subjects. Conclusion: The pulsed electromagnetic field may be an alternative treatment modality in diabetic patients with neuropathic pain. Amaç: Diyabetik periferik nöropati, diyabetin en sık görülen ve özürlülüğe neden olan komplikasyonudur. Nöropatik ağrı sıklıkla çoklu farmakolojik tedaviye dirençlidir ve bu ajanların yan etkileri kullanımlarını sınırlar. Nöropatik ağrı tedavisinde farklı alternatif tedaviler araştırılmaktadır. Nonfarmakolojik tedavilerin sistemik yan etkileri düşüktür. Bu rasgele seçilmiş, plasebo kontrollü çalışmada, dirençli diyabetik nöropatik ağrıda puls elektromanyetik alan tedavisinin etkinliği araştırıldı. Hastalar ve Yöntemler: Çalışma, rasgele ayrılan, 25 puls elektromanyetik alan tedavisi (PEMF) ve 25 plasebo grubunda olmak üzere 50 hastayla tamamlandı. Tedavi grubundaki hastaların her iki ayağına on ardışık gün ve günde 1 saat PEMF uygulandı. Olguların tedaviden önce, sonra ve 6. haftadaki kontrollerinde vizüel analog skala ve nöropatik ağrı skala değerlendirmeleri yapıldı. Elektronöromiyografi tetkikleri, tedaviden önce ve 6. hafta kontrollerinde değerlendirildi. Bulgular: Çalışmanın sonucunda, vizüel analog skala ile yapılan ağrı değerlendirmesinde tedavi sonunda %53, kontrol değerlendirmesinde %67 iyileşme saptandı. Nöropatik ağrı skalası farklı verilerinde saptanan düzelme, tedavi grubunda plasebo grubuna göre istatistiksel olarak anlamlıydı. Sinir ileti hızı çalışmalarında iki grup verileri arasında anlamlı istatistiksel fark saptanmadı. Sonuç: Puls elektromanyetik alan tedavisi, ağrı skorları ve polinöropati semptomları üzerindeki olumlu etkileri ile diyabetik nöropatik ağrı tedavisinde alternatif bir seçenek olarak düşünülebilir.

References

  • Vinik AI, Mehrabyan A. Diabetic neuropathies. Med Clin North Am 2004;88:947-99.
  • Brunton S. Approach to assessment and diagnosis of chronic pain. J Fam Pract 2004;53(10 Suppl):S3-10.
  • Shah SJ. Rehabilitation in diabetic neuropathy. Int J Diabetes Dev Ctries 2003;23:99-103.
  • Weintraub MI, Wolfe GI, Barohn RA, Cole SP, Parry GJ, Hayat G, et al. Static magnetic field therapy for symptomatic diabetic neuropathy: a randomized, double-blind, placebo-controlled trial. Arch Phys Med Rehabil 2003;84:736-46.
  • Cañedo-Dorantes L, García-Cantú R, Barrera R, MéndezRamírez I, Navarro VH, Serrano G. Healing of chronic arterial and venous leg ulcers through systemic effects of electromagnetic fields. Arch Med Res 2002;33:281-9.
  • Stiller MJ, Pak GH, Shupack JL, Thaler S, Kenny C, Jondreau L. A portable pulsed electromagnetic field (PEMF) device to enhance healing of recalcitrant venous ulcers: a double-blind, placebo-controlled clinical trial. Br J Dermatol 1992;127:147-54.
  • Baron R. Peripheral neuropathic pain: from mechanisms to symptoms. Clin J Pain 2000;16(2 Suppl):S12-20.
  • Cruccu G, Anand P, Attal N, Garcia-Larrea L, Haanpää M, Jørum E, et al. EFNS guidelines on neuropathic pain assessment. Eur J Neurol 2004;11:153-62.
  • Basford JR. A historical perspective of the popular use of electric and magnetic therapy. Arch Phys Med Rehabil 2001;82:1261-9.
  • Zinman LH, Ngo M, Ng ET, Nwe KT, Gogov S, Bril V. Lowintensity laser therapy for painful symptoms of diabetic sensorimotor polyneuropathy: a controlled trial. Diabetes Care 2004;27:921-4.
  • Tesfaye S, Kempler P. Painful diabetic neuropathy. Diabetologia 2005;48:805-7.
  • Weintraub MI, Cole SP. Pulsed magnetic field therapy in refractory neuropathic pain secondary to peripheral neuropathy: electrodiagnostic parameters--pilot study. Neurorehabil Neural Repair 2004;18:42-6.
  • Argoff CE, Cole BE, Fishbain DA, Irving GA. Diabetic peripheral neuropathic pain: clinical and quality-of-life issues. Mayo Clin Proc 2006;81(4 Suppl):S3-11.
  • Tavakoli M, Malik RA. Management of painful diabetic neuropathy. Expert Opin Pharmacother 2008;9:2969-78.
  • Boulton AJ, Malik RA. Diabetic neuropathy. Med Clin North Am 1998;82:909-29.
  • Reichstein L, Labrenz S, Ziegler D, Martin S. Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation. Diabetologia 2005;48:824-8.
  • Boulton AJ. Diabetic neuropathy: classification, measurement and treatment. Curr Opin Endocrinol Diabetes Obes 2007;14:141-5.
  • Waxman SG, Cummins TR, Dib-Hajj SD, Black JA. Voltagegated sodium channels and the molecular pathogenesis of pain: a review. J Rehabil Res Dev 2000;37:517-28.
  • Eglen RM, Hunter JC, Dray A. Ions in the fire: recent ionchannel research and approaches to pain therapy. Trends Pharmacol Sci 1999;20:337-42.
  • Horn S, Quasthoff S, Grafe P, Bostock H, Renner R, Schrank B. Abnormal axonal inward rectification in diabetic neuropathy. Muscle Nerve 1996;19:1268-75.
  • Winemiller MH, Billow RG, Laskowski ER, Harmsen WS. Effect of magnetic vs sham-magnetic insoles on nonspecific foot pain in the workplace: a randomized, double-blind, placebo-controlled trial. Mayo Clin Proc 2005;80:1138-45.
  • Musaev AV, Guseinova SG, Imamverdieva SS. The use of pulsed electromagnetic fields with complex modulation in the treatment of patients with diabetic polyneuropathy. Neurosci Behav Physiol 2003;33:745-52.
  • Aksoy C. Manyetik alan tedavisi. İçinde: Tuna N, editör. Elektroterapi. 2. baskı. İstanbul: Nobel Tıp Kitabevi; 2001. s. 119-27.
  • Argoff CE, Galer BS, Jensen MP, Oleka N, Gammaitoni AR. Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain states: assessment with the Neuropathic Pain Scale. Curr Med Res Opin 2004;20 Suppl 2:S21-8.
  • Jensen MP, Friedman M, Bonzo D, Richards P. The validity of the neuropathic pain scale for assessing diabetic neuropathic pain in a clinical trial. Clin J Pain 2006;22:97-103.
  • Ziegler D. Polyneuropathy in the diabetic patient--update on pathogenesis and management. Nephrol Dial Transplant 2004;19:2170-5.
  • Feldman EL, Stevens MJ, Thomas PK, Brown MB, Canal N, Greene DA. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care 1994;17:1281-9.
  • Escobar-Rodríguez DA, Rivera-Ibarra DB, Juárez-López Mde J, González-Carmona B. Contribution of electroneuromyography to the evaluation of neuropathy in diabetic patients. Rev Med Inst Mex Seguro Soc 2006;44:27-34. [Abstract]
  • Baba M, Ozaki I. Electrophysiological changes in diabetic neuropathy: from subclinical alterations to disabling abnormalities. Arch Physiol Biochem 2001;109:234-40.
  • Detlavs I, Dombrovska L, Turauska A, Shkirmante B, Slutskii L. Experimental study of the effects of radiofrequency electromagnetic fields on animals with soft tissue wounds. Sci Total Environ 1996;180:35-42.
  • Ramey DW. Magnetic and electromagnetic therapy. Scientific Review of Alternative Medicine 1998;2:13-9.
  • Markov MS. Expanding use of pulsed electromagnetic field therapies. Electromagn Biol Med 2007;26:257-74.
  • Nikolaeva NV, Bolotova V, Luk'ianov VF, Raĭgorodskiĭ IuM, Tkacheva EN. Non-pharmacological treatment of microcirculation disturbance in children with diabetic polyneuropathy. Zh Nevrol Psikhiatr Im S S Korsakova 2008;108:43-6. [Abstract]
  • Nicholson B. Gabapentin use in neuropathic pain syndromes. Acta Neurol Scand 2000;101:359-71.
  • Harati Y, Gooch C, Swenson M, Edelman S, Greene D, Raskin P, et al. Double-blind randomized trial of tramadol for the treatment of the pain of diabetic neuropathy. Neurology 1998;50:1842-6.
  • Backonja M, Beydoun A, Edwards KR, Schwartz SL, Fonseca V, Hes M, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998;280:1831-6.

Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği

Year 2010, Volume: 2010 Issue: 4, 227 - 233, 01.04.2010
https://doi.org/10.5174/tutfd.2009.01556.2

Abstract

Amaç: Diyabetik periferik nöropati, diyabetin en sık görülen
ve özürlülüğe neden olan komplikasyonudur. Nöropatik ağrı
sıklıkla çoklu farmakolojik tedaviye dirençlidir ve bu ajanların
yan etkileri kullanımlarını sınırlar. Nöropatik ağrı tedavisinde
farklı alternatif tedaviler araştırılmaktadır. Nonfarmakolojik
tedavilerin sistemik yan etkileri düşüktür. Bu rasgele seçilmiş,
plasebo kontrollü çalışmada, dirençli diyabetik nöropatik ağrı-
da puls elektromanyetik alan tedavisinin etkinliği araştırıldı.
Hastalar ve Yöntemler: Çalışma, rasgele ayrılan, 25 puls
elektromanyetik alan tedavisi (PEMF) ve 25 plasebo grubunda
olmak üzere 50 hastayla tamamlandı. Tedavi grubundaki
hastaların her iki ayağına on ardışık gün ve günde 1 saat
PEMF uygulandı. Olguların tedaviden önce, sonra ve 6.
haftadaki kontrollerinde vizüel analog skala ve nöropatik ağrı
skala değerlendirmeleri yapıldı. Elektronöromiyografi tetkikleri,
tedaviden önce ve 6. hafta kontrollerinde değerlendirildi.
Bulgular: Çalışmanın sonucunda, vizüel analog skala ile
yapılan ağrı değerlendirmesinde tedavi sonunda %53,
kontrol değerlendirmesinde %67 iyileşme saptandı.
Nöropatik ağrı skalası farklı verilerinde saptanan düzelme,
tedavi grubunda plasebo grubuna göre istatistiksel
olarak anlamlıydı. Sinir ileti hızı çalışmalarında iki grup
verileri arasında anlamlı istatistiksel fark saptanmadı.
Sonuç: Puls elektromanyetik alan tedavisi, ağrı skorları
ve polinöropati semptomları üzerindeki olumlu etkileri ile
diyabetik nöropatik ağrı tedavisinde alternatif bir seçenek
olarak düşünülebilir.

References

  • Vinik AI, Mehrabyan A. Diabetic neuropathies. Med Clin North Am 2004;88:947-99.
  • Brunton S. Approach to assessment and diagnosis of chronic pain. J Fam Pract 2004;53(10 Suppl):S3-10.
  • Shah SJ. Rehabilitation in diabetic neuropathy. Int J Diabetes Dev Ctries 2003;23:99-103.
  • Weintraub MI, Wolfe GI, Barohn RA, Cole SP, Parry GJ, Hayat G, et al. Static magnetic field therapy for symptomatic diabetic neuropathy: a randomized, double-blind, placebo-controlled trial. Arch Phys Med Rehabil 2003;84:736-46.
  • Cañedo-Dorantes L, García-Cantú R, Barrera R, MéndezRamírez I, Navarro VH, Serrano G. Healing of chronic arterial and venous leg ulcers through systemic effects of electromagnetic fields. Arch Med Res 2002;33:281-9.
  • Stiller MJ, Pak GH, Shupack JL, Thaler S, Kenny C, Jondreau L. A portable pulsed electromagnetic field (PEMF) device to enhance healing of recalcitrant venous ulcers: a double-blind, placebo-controlled clinical trial. Br J Dermatol 1992;127:147-54.
  • Baron R. Peripheral neuropathic pain: from mechanisms to symptoms. Clin J Pain 2000;16(2 Suppl):S12-20.
  • Cruccu G, Anand P, Attal N, Garcia-Larrea L, Haanpää M, Jørum E, et al. EFNS guidelines on neuropathic pain assessment. Eur J Neurol 2004;11:153-62.
  • Basford JR. A historical perspective of the popular use of electric and magnetic therapy. Arch Phys Med Rehabil 2001;82:1261-9.
  • Zinman LH, Ngo M, Ng ET, Nwe KT, Gogov S, Bril V. Lowintensity laser therapy for painful symptoms of diabetic sensorimotor polyneuropathy: a controlled trial. Diabetes Care 2004;27:921-4.
  • Tesfaye S, Kempler P. Painful diabetic neuropathy. Diabetologia 2005;48:805-7.
  • Weintraub MI, Cole SP. Pulsed magnetic field therapy in refractory neuropathic pain secondary to peripheral neuropathy: electrodiagnostic parameters--pilot study. Neurorehabil Neural Repair 2004;18:42-6.
  • Argoff CE, Cole BE, Fishbain DA, Irving GA. Diabetic peripheral neuropathic pain: clinical and quality-of-life issues. Mayo Clin Proc 2006;81(4 Suppl):S3-11.
  • Tavakoli M, Malik RA. Management of painful diabetic neuropathy. Expert Opin Pharmacother 2008;9:2969-78.
  • Boulton AJ, Malik RA. Diabetic neuropathy. Med Clin North Am 1998;82:909-29.
  • Reichstein L, Labrenz S, Ziegler D, Martin S. Effective treatment of symptomatic diabetic polyneuropathy by high-frequency external muscle stimulation. Diabetologia 2005;48:824-8.
  • Boulton AJ. Diabetic neuropathy: classification, measurement and treatment. Curr Opin Endocrinol Diabetes Obes 2007;14:141-5.
  • Waxman SG, Cummins TR, Dib-Hajj SD, Black JA. Voltagegated sodium channels and the molecular pathogenesis of pain: a review. J Rehabil Res Dev 2000;37:517-28.
  • Eglen RM, Hunter JC, Dray A. Ions in the fire: recent ionchannel research and approaches to pain therapy. Trends Pharmacol Sci 1999;20:337-42.
  • Horn S, Quasthoff S, Grafe P, Bostock H, Renner R, Schrank B. Abnormal axonal inward rectification in diabetic neuropathy. Muscle Nerve 1996;19:1268-75.
  • Winemiller MH, Billow RG, Laskowski ER, Harmsen WS. Effect of magnetic vs sham-magnetic insoles on nonspecific foot pain in the workplace: a randomized, double-blind, placebo-controlled trial. Mayo Clin Proc 2005;80:1138-45.
  • Musaev AV, Guseinova SG, Imamverdieva SS. The use of pulsed electromagnetic fields with complex modulation in the treatment of patients with diabetic polyneuropathy. Neurosci Behav Physiol 2003;33:745-52.
  • Aksoy C. Manyetik alan tedavisi. İçinde: Tuna N, editör. Elektroterapi. 2. baskı. İstanbul: Nobel Tıp Kitabevi; 2001. s. 119-27.
  • Argoff CE, Galer BS, Jensen MP, Oleka N, Gammaitoni AR. Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain states: assessment with the Neuropathic Pain Scale. Curr Med Res Opin 2004;20 Suppl 2:S21-8.
  • Jensen MP, Friedman M, Bonzo D, Richards P. The validity of the neuropathic pain scale for assessing diabetic neuropathic pain in a clinical trial. Clin J Pain 2006;22:97-103.
  • Ziegler D. Polyneuropathy in the diabetic patient--update on pathogenesis and management. Nephrol Dial Transplant 2004;19:2170-5.
  • Feldman EL, Stevens MJ, Thomas PK, Brown MB, Canal N, Greene DA. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care 1994;17:1281-9.
  • Escobar-Rodríguez DA, Rivera-Ibarra DB, Juárez-López Mde J, González-Carmona B. Contribution of electroneuromyography to the evaluation of neuropathy in diabetic patients. Rev Med Inst Mex Seguro Soc 2006;44:27-34. [Abstract]
  • Baba M, Ozaki I. Electrophysiological changes in diabetic neuropathy: from subclinical alterations to disabling abnormalities. Arch Physiol Biochem 2001;109:234-40.
  • Detlavs I, Dombrovska L, Turauska A, Shkirmante B, Slutskii L. Experimental study of the effects of radiofrequency electromagnetic fields on animals with soft tissue wounds. Sci Total Environ 1996;180:35-42.
  • Ramey DW. Magnetic and electromagnetic therapy. Scientific Review of Alternative Medicine 1998;2:13-9.
  • Markov MS. Expanding use of pulsed electromagnetic field therapies. Electromagn Biol Med 2007;26:257-74.
  • Nikolaeva NV, Bolotova V, Luk'ianov VF, Raĭgorodskiĭ IuM, Tkacheva EN. Non-pharmacological treatment of microcirculation disturbance in children with diabetic polyneuropathy. Zh Nevrol Psikhiatr Im S S Korsakova 2008;108:43-6. [Abstract]
  • Nicholson B. Gabapentin use in neuropathic pain syndromes. Acta Neurol Scand 2000;101:359-71.
  • Harati Y, Gooch C, Swenson M, Edelman S, Greene D, Raskin P, et al. Double-blind randomized trial of tramadol for the treatment of the pain of diabetic neuropathy. Neurology 1998;50:1842-6.
  • Backonja M, Beydoun A, Edwards KR, Schwartz SL, Fonseca V, Hes M, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998;280:1831-6.
There are 36 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Pervin Fezyioğlu This is me

Ferda Özdemir This is me

Ferda Özdemir This is me

Sibel Güldiken This is me

Kemal Balcı This is me

Necdet Süt This is me

Publication Date April 1, 2010
Published in Issue Year 2010 Volume: 2010 Issue: 4

Cite

APA Fezyioğlu, P., Özdemir, F., Özdemir, F., Güldiken, S., et al. (2010). Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği. Balkan Medical Journal, 2010(4), 227-233. https://doi.org/10.5174/tutfd.2009.01556.2
AMA Fezyioğlu P, Özdemir F, Özdemir F, Güldiken S, Balcı K, Süt N. Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği. Balkan Medical Journal. April 2010;2010(4):227-233. doi:10.5174/tutfd.2009.01556.2
Chicago Fezyioğlu, Pervin, Ferda Özdemir, Ferda Özdemir, Sibel Güldiken, Kemal Balcı, and Necdet Süt. “Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği”. Balkan Medical Journal 2010, no. 4 (April 2010): 227-33. https://doi.org/10.5174/tutfd.2009.01556.2.
EndNote Fezyioğlu P, Özdemir F, Özdemir F, Güldiken S, Balcı K, Süt N (April 1, 2010) Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği. Balkan Medical Journal 2010 4 227–233.
IEEE P. Fezyioğlu, F. Özdemir, F. Özdemir, S. Güldiken, K. Balcı, and N. Süt, “Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği”, Balkan Medical Journal, vol. 2010, no. 4, pp. 227–233, 2010, doi: 10.5174/tutfd.2009.01556.2.
ISNAD Fezyioğlu, Pervin et al. “Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği”. Balkan Medical Journal 2010/4 (April 2010), 227-233. https://doi.org/10.5174/tutfd.2009.01556.2.
JAMA Fezyioğlu P, Özdemir F, Özdemir F, Güldiken S, Balcı K, Süt N. Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği. Balkan Medical Journal. 2010;2010:227–233.
MLA Fezyioğlu, Pervin et al. “Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği”. Balkan Medical Journal, vol. 2010, no. 4, 2010, pp. 227-33, doi:10.5174/tutfd.2009.01556.2.
Vancouver Fezyioğlu P, Özdemir F, Özdemir F, Güldiken S, Balcı K, Süt N. Dirençli Diyabetik Nöropatik Ağrıda Puls Elektromanyetik Alan Tedavisinin Etkinliği. Balkan Medical Journal. 2010;2010(4):227-33.