Treating Diabetic Neuropathy

Neuropathy

Treating diabetic neuropathy is something I have seen a number of different physicians advertising. It was something I didn’t think I would get into because it is not exactly my area of expertise. I have focused most of my career on spinal rehabilitation for a wide array of spine related conditions but never considered what we do could have an affect on diabetic neuropathy. What changed was a patient of ours who comes in because our care helps manage his diabetic neuropathy. Bob did a video testimonial for us which I will be getting up soon but he is emphatic that if it wasn’t for our BStrong4Life program he would not be doing as good as he is today.

After sitting down to do his testimonial we got to talking and he was so emphatic that our program helped his neuropathy that it is something we should promote. I, understanding that one case of a patient improving is not necessarily enough evidence to support a modality, did a little research into this topic. I found some very interesting studies which validate what Bob has been noticing in his pain and function. The topic of this blog post is to highlight these studies to show that Bob’s results are not exactly random and perhaps something we should expect to see in other patients with diabetic neuropathy. There are not many studies on vibration to treat diabetic neuropathy but the few that exist show a positive benefit.

As not to bore you too much with research I am going to go over these really quickly. I will link to the studies in the text below for you to read the actual studies if you wish.

There are two case reports published by the same authors one in 2011 and the other in 2013. Both studies involved men, one aged 64 and the other aged 71. In both cases the patients tried several other treatment options fore managing their neuropathy without significant pain relief. In one study the patient underwent 4 weeks of care and in the other the patient had 8 weeks of care. In both cases the treatment was simply placing their feet on the vibration platform for several minutes. In both cases the patients noticed significant improvement in pain. In the 2013 case the patient was treated in the mornings and did not have any foot pain until late that night or early the next day. In the 2013 case the patient’s reported pain levels prior to the treatment was 8/10 for the right foot and 6/10 for the left. After treatment his pain level was reported as a 1/10 for the right foot and 0/10 for the left. In both cases the researchers measured the patients gait and balance and found measurable improvements in both as well. There cases suggest that using a vibration platform can help in improve pain and function.

There are two pilot studies one from 2013 and one from 2014 by different researchers. A pilot study uses very small sample sizes and is done primarily to determine if a larger study is feasible but the authors always mention the patient results as well. The 2013 study was on pain and function with a sample size of 8 patients. The authors found that a 3 day a week treatment schedule for 4 weeks resulted in significant acute and chronic diabetic neuropathic pain reduction.  The 2014 study looked at  leg muscle strength and balance in ten patients who underwent one treatment session on a vibration platform. The authors found that one session of treatment had a significant affect on muscle strength and balance. The authors of this 2014 paper published a larger study in 2015 looking at these same parameters; muscle strength and balance in type 2 diabetic patients with peripheral neuropathy. In this study they had 20 patients; ten in a treatment group on a vibration platform and ten in a control group receiving no care but stood on a platform that did not vibrate or move at all. In this study the authors found that after 6 weeks of patients presenting for care twice a week the treatment group had significant increases in strength and balance where the control or placebo group had no increase in strength or balance. They also reported no complications in the treatment group indicating that training on a vibration platform was safe. These studies combined show that training on a vibration platform is safe and effective to reduce pain associated with diabetic neuropathy as well as improving strength and balance.

These last two studies I’ll mention go beyond just pain, strength, and balance but also measure other affects in a way to try to determine why vibration training can improve pain and function in patients with diabetic neuropathy. This first study was published in 2013 measured strength and balance as well as patient HbA1c levels which is used as a predictor for the progression of diabetes. The authors of this study divided 55 elderly patients into 3 groups, one who were treated with whole body vibration and balance exercises, one group who got only balance exercises without whole body vibration, and a control group who received no treatments. The authors found that the group who were treated with whole body vibration had significant improvement in strength, balance, and HbA1c levels. This study is really neat because it confirms findings in other studies on strength and balance but also shows that training on vibration platforms could help with controlling the patients diabetes. This last study measured skin blood flow and whole blood nitric oxide concentrations before and after ten 1-minute bouts of whole body vibration exposure. Compared to a group of patients who were given a sham or placebo treatment the whole body vibration group had a significant increase in skin blood flow following whole body vibration. The placebo group did not. Nitric oxide concentrations where improved in the whole body vibration group but not to a level that was statistically significant over the placebo group. The takeaway from this study is the physiological effects of using vibration therapy. There is improvement in blood flow as a direct response to training on a whole body vibration platform. The authors provide some reason as to why they did no measure a significant difference in nitric oxide concentration and propose other methods to measure that for future studies.

What we are looking at with these studies is the evidence that supports what our patient Bob has been noticing since he started coming in for our BStrong4Life program and why he continues to come in. There is a positive effect that whole body vibration has on pain related to diabetic neuropathy, there is a positive effect on strength and balance, and even a positive effect on blood glucose and blood oxygen levels. I would like to mention that in all of these studies the authors used specific vibration platforms because not all vibration platforms are made the same. Our platforms were used in several of the studies listed here. I say this because you will not likely be able to replicate these results unless you are using certain types of vibration platforms like ours.

In conclusion it is very likely that if you are suffering from diabetic neuropathy we can tailor our BStrong4Life program to match what was done in these studies to give you the same relief they and Bob feels after care.

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Posted in Healthcare Policy and Politics, Injury Prevention, Uncategorized, Wellness

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