Spinal Cord Stimulation for Diabetic Neuropathy Pain: Is It Effective?

Spinal cord stimulation (SCS) effectively relives pain and restores nerve function in patients with painful diabetic peripheral neuropathy (DPN), according to the findings of a small study presented at the 2025 American Academy of Neurology (AAN) annual meeting, held from April 5 to 9, 2025, in San Diego, California.

Researchers studied the effects of SCS on DPN pain because of the limitations of conventional therapy in treating pain and other sensory deficits in DPN. In addition, there is lack of recognition of the autonomic dysfunction in this patient population.

Eligible participants had classic “stocking-and-glove” painful DPN affecting lower and upper limbs. The SCS was implanted as a 4-port system and percutaneous leads at thoracic (T10-T12) and cervical (C5-T1) levels.

Participants received assessments before and after SCS implantation at 3, 6, and 12 months. They completed questionnaires for pain, quality of life, sleep, and autonomic impairment, including visual analog scale (VAS), Neuropathic Pain Symptom Inventory (NPSI), and Boston Autonomic Symptom Questionnaire (BASQ). Participants also underwent tests for neurologic function, such as electromyogram (EMG), nerve conduction studies (NCS), neurologic exam (Utah Early Neuropathic Scale [UENS]), hands and feet skin conductance and thermography, and small-fiber density quantification.

A total of 11 patients with painful DPN received SCS implants.

At around the 8-month follow-up, 8 (72.7%) patients reported improvements in pain (VAS: 8.6 to 1.7 in lower limbs and 6.2 to 1.1 in upper limbs; P <.05), as well as neuropathic symptoms (NPSI: 42 to 8; P <.05) and autonomic symptoms, including orthostatic, genital/sexual, and pupillomotor (BASQ: 27.9 to 16.7; P =.018).

Participants also showed neurologic recovery in the large- and small-fibers function, including improved neurologic exam (UENS: 21 to 13; P =.027); lesser EMG; improved sensory NCS; improved sudomotor function, as observed by a decrease in feet temperature (30.8 ºC to 26.7 ºC; P =.04); and increased skin conductance in soles of feet (38 to 46 micro Siemens [µS]).

The researchers concluded, “Our current data indicate that SCS can effectively treat [painful] DPN by eliciting relief of pain, sensory and autonomic symptoms, and restoring large- and small-nerve function.”

Multiple authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.