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Evidence‐based guideline: Treatment of painful diabetic neuropathy—report of the american association of neuromuscular and electrodiagnostic medicine, the american academy of neurology, and the american academy of physical medicine & rehabilitation
Author(s) -
Bril Vera,
England John D.,
Franklin Gary M.,
Backonja Miroslav,
Cohen Jeffrey A.,
Del Toro David R.,
Feldman Eva L.,
Iverson Donald J.,
Perkins Bruce,
Russell James W.,
Zochodne Douglas W.
Publication year - 2011
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.22092
Subject(s) - medicine , duloxetine , pregabalin , gabapentin , neurology , massage , guideline , acupuncture , physical therapy , diabetic neuropathy , neuropathic pain , pain medicine , evidence based medicine , intensive care medicine , anesthesia , alternative medicine , anesthesiology , psychiatry , diabetes mellitus , pathology , endocrinology
The objective of this report was to develop a scientifically sound and clinically relevant evidence‐based guideline for the treatment of painful diabetic neuropathy (PDN). The basic question that was asked was: “What is the efficacy of a given treatment (pharmacological: anticonvulsants, antidepressants, opioids, others; non‐pharmacological: electrical stimulation, magnetic field treatment, low‐intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?” A systematic review of literature from 1960 to August 2008 was performed, and studies were classified according to the American Academy of Neurology classification of evidence scheme for a therapeutic article. Recommendations were linked to the strength of the evidence. The results indicate that pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and oxycodone controlled‐release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence, or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness. Few studies have sufficient information on their effects on function and QOL. Muscle Nerve, 2011.