Adding PEMF to Medications for Diabetic Peripheral Neuropathy

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Journal of
Lasers
in Medical Sciences
http://journals.sbmu.ac.ir/jlms
doi 10.15171/jlms.2020.05
J Lasers Med Sci 2020 Winter;11(1):20-28
Original Article
The Efficacy of Adding Electromagnetic Therapy or Laser Therapy to Medications in Patients With Diabetic Peripheral Neuropathy
Alsayed A. Shanb1*, Enas F. Youssef1, Waleed I. Al Baker2, Fahd A. Al-Khamis3, Ali Hassan3, Noor-Ahmad Jatoi4
1Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, KSA
2Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA 3Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
4Department of Internal Medicine, King Fahd University Hospital and College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
*Correspondence to
Alsayed A. Shanb,
Fax: +9663330343;
Tel: +966555786349; Email: aashanb@iau.edu.sa
Published online January 18, 2020
Abstract
Introduction: Diabetes mellitus (DM) is a common disease with a highly significant burden among the Saudi population. This study aimed to investigate the effects of adding either magnetic or laser therapy to medications in patients with diabetic peripheral neuropathy (DPN).
Methods: Seventy-one medically controlled diabetic patients were randomly assigned to 1) Magnetic group: 26 patients were exposed to magnetic therapy for 20 minutes/session, 2 sessions/week, for 3 months 2) Laser group: 25 patients were exposed to laser therapy with intensity 5.7 J/cm2 for 30 minutes/session, 2 times/week, for 3 months. 3) Drug group: 20 patients received only the regular medications for diabetic control and pain analgesia. Pain and neuropathy were assessed by the visual analog scale (VAS) and the Toronto Clinical Neuropath Scoring System (TRCNSS). Conduction velocities and amplitudes of peroneal and sural nerves were measured by electromyography. Results: The results showed significant increases in conduction velocities and amplitudes in both magnetic and laser groups in parallel with significant reductions in TRCNSS. Non-significant changes were obtained only after using only medications (P>0.05). The mean values of VAS reduced significantly in the three groups. The least significant differences showed significant changes among the three groups, whereas non-significant differences were obtained between both magnetic and laser groups.
Conclusion: There were non-significant differences between both magnetic and laser therapy groups. Addition of either magnetic or laser therapy to medications could bring extra positive benefits to patients with DPN. Both magnetic and laser therapy can be applied with medications for the treatment of patients with DPN.
Keywords: Neuropathic pain; Laser therapy; Conduction velocity.
Introduction
Diabetes mellitus (DM) is a common disease which is accompanied by a highly significant social and economic burden.1 Diabetes has high prevalence and progressive rates among the Saudi population. It is strongly associated with both microvascular and macrovascular complications such as retinopathy, neuropathy, and cardiovascular diseases.2 Peripheral neuropathy is the most common complication of diabetic patients.3 Diabetic peripheral neuropathy (DPN) is commonly associated with a high rate of patients’ mortality and morbidity.4 The prevalence and progression of DPN increase in parallel with the chronicity of diabetes, poor glycemic control and pre-existing cardiovascular risk factors.3 DPN is usually characterized by increases in pain severity, impairments
in tactile and proprioceptive sensation, vibration sense, and improper postural control.5 Distal symmetric polyneuropathy is the commonest form of diabetic neuropathy.6
Nevertheless, diagnostic methods of neuropathy are diverse. The highest sensitive and objective method is the conduction velocity test (CVT).6 Diagnosis of DPN is confirmed when the symptoms and signs of peripheral nerve dysfunctions are present after the exclusion of all other causes.3 Comprehensive evaluation of DPN also requires careful examination of the lower extremity with validated clinical tests such as light touch, vibration, and the Toronto Clinical Neuropathy Scoring System (TRCNSS) which is one of the most sensitive clinical scales to detect early neuropathies.7
Please cite this article as follows: Shanb AA, Youssef EF, Al Baker WI, Al-Khamis FA, Hassan A, Jatoi NA. The efficacy of adding electromagnetic therapy or laser therapy to medications in patients with diabetic peripheral neuropathy. J Lasers Med Sci. 2020;11(1):20- 25. doi:10.15171/jlms.2020.05.