Electrotherapy Interventions for Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN) is characterized by a decrease in nerve activity throughout the body, which may interfere with motor and sensory functions as well autonomic regulation. Electrotherapy may potentially have analgesic effects due to local release of neurotransmitters including serotonin, increase production of mitochondrial ATP, and endorphin release. Another possible mechanism of action for electrotherapy is the activation of the dorsal column. Pain input is blocked by inhibition of C fibers. It has been seen that transcutaneous electrical nerve stimulation (TENS) given with high frequency reduces the human motor cortex’s state of excitability. These findings imply toward short-term inhibitory influence on both the sensory and motor systems produced by TENS. Low-power laser therapy is frequently used to treat diabetic foot because it promotes better microcirculation and heals ulcers. In addition, electromagnetic fields produce vasodilation and have analgesic, anti-inflammatory, and anti-swelling properties. They are regarded as a reliable adjuvant therapy for DPN patients. Neurostimulation is widely adapted in recent times in the form of transcranial stimulation with direct current or magnetic stimulation (tDCS and rTMS), stimulation of motor cortex ((MCS), stimulation of spinal cord, stimulation of peripheral nerve, and stimulation of dorsal root ganglion. Given that pulsed electromagnetic stimulation (PEMF) can alter pain and some electrophysiological aspects of peripheral nerve activity, it may prove to be a useful therapeutic option for the management of painful diabetic neuropathy.