Diabetic Neuropathy 101

 Burning, stabbing, shooting pain are all common symptoms of someone with DPN or Diabetic peripheral neuropathy. Having DPN can significantly impact ones daily activities and lifestyle. DPN is a complication of diabetes which is presented in many different forms and often being referred as diabetic sciatic pain. Diabetes affects over 11% of the US population and of which over 40% develop DPN. Being that this disease is so prevalent within our society and community it is essential to understand what preventative measures or treatments are available for those within our communities. 

This study focuses on manual therapy and exercises with a focus on lower limbs of patients with DPN. Various different intervention methods were used such as aerobics or gait training all of which encompass the idea of exercises for patients with limited mobility or limited impact. Pedro scale was used to help determine the results of the study of which it was found that after 12 weeks of exercise various nerves such as the motor tibial or peroneal nerve have improved the neuropathic conduction velocity. Patients described this as lower frequency of pain and or discomfort. In this study it is important to note that along with the change in exercise patterns overall lifestyle and diet changes were also made. 

While working at my local clinic I was fortunate enough to work with a patient with DPN. This patient had been experiencing these pains for years before being diagnosed with diabetes. Multiple different medications were tried, none with much success. I found myself working with this patient once again at this summer's internship at a Physical therapy clinic. This patient had significant weight loss 250lb to under 200lb. I learned that with the weight loss and exercise treatments he had been receiving he has felt a significant decrease in the frequency of his DPN pain. He explained that when he would take a traditional exercise route of walking or weight lifting he would experience sharp pain especially after working. Via water aerobics he was able to decrease the impact on his joints and feet resulting in a decrease in pain frequency. 

This study had many confounding variables which was further highlighted with my patient in which many of these studies do not account for variables such as economic status or lifestyle. I questioned about, How these studies cater more to the main population affected while also taking into account the various lifestyles and limitations? It essential to explore more deeply into these differences in order to be able to better help various communities. 

Sharma, Jyoti, et al. “Effects of exercises and manual therapy on nerve conduction studies of lower limb in patients with diabetes and diabetic peripheral neuropathy: A systematic review.” International Journal of Diabetes in Developing Countries, vol. 44, no. 2, 23 Oct. 2023, pp. 241–264, https://doi.org/10.1007/s13410-023-01258-5.