Currently,
diabetes mellitus (DM) is relevant problem, both for its prevalence and complications, including distal
polyneuropathy (DPNP). At the same time, discussions continue on
analgesic efficacy of
transcutaneous electrical nerve stimulation (
TENS) in DPNP. Aim of this study was to conduct a multi-faceted assessment of
pain syndrome in these patients before and after
TENS, taking into account levels of
polyneuropathy, its severity and age of patients. The study was conducted in accordance with the research of the Federal State Budgetary Institution of the National Medical Research Center for Rehabilitation and
Balneology of the Ministry of Health of the Russian Federation (CTR No. 121040100062-3) and with the permission of the Local Ethics Committee (IRB No. 2 dated 14.01.2021). The study included 75 patients with DM type II with DPNP, which are distributed into 3 groups of 25 people: Group 1a, patients received high-frequency
TENS (HF); Group Ib, patients received low-frequency
TENS (LF); as control, Group C received a standard method of pharmacological
therapy without physiotherapy. Intensity of DPNP was evaluated before and after the course of treatment using a visual analog scale (VAS), the McGill
Pain Questionnaire (MPQ), and a graphical linear analysis of
pain on the
neuropathic pain diagnostic questionnaire 4 (DN4) scale.
TENS provides an
analgesic effect that may exceed
pharmacotherapy in terms of efficacy and safety. There was a 65.9% reduction in
neuropathic pain according to VAS after a course of application, with the effects remaining up to 34% during the 6-month follow-up. HF
TENS provided a higher significant
analgesic effects than LF
TENS, as it ensures the reduction of
pain syndrome according to VAS by 25.8% (p <0.01), and total estimated characteristics - 35.5% (p <0.01), and touch - in at 58.1% (p = 0.001) and according to the scales of the MPQ (S) and DN4 - by 21% (p = 0.007). The observed differences in
analgesic effects between HF
TENS and LF
TENS are based on analyses of
pain in the immediate and long-term follow-up periods of type II DM patients with DPNP. These results, based on summation of the estimated parameters of the international
pain scales support expectation of an expansion of the the use of
analgesic TENS in aging patients suffering with DM of varying severity and extent of DPNP damage, a goal of great scientific and practical importance.