Perineural Platelet-Rich Plasma for Diabetic Neuropathic Pain, Could It Make a Difference?

Manal Hassanien, Abdelraheem Elawamy, Emad Zarief Kamel, Walaa A Khalifa, Ghada Mohamed Abolfadl, Al Shimaa Ismael Roushdy, Randa A El Zohne, Yasmine S Makarem

Journal: Pain medicine (Malden, Mass.) 2021;21(4):757-765

PMID: 31298289

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Abstract

OBJECTIVE

To evaluate the clinical effect of perineural platelet-rich plasma (PRP) injection for pain and numbness alleviation in diabetic peripheral neuropathy (DPN).

STUDY DESIGN

A randomized prospective clinical trial.

SETTING

Pain clinic and Rheumatology and Rehabilitation Departments, Assiut University Hospital.

METHODS

Sixty adult patients with type II DM accompanied by DPN of at least six months' duration were assessed by modified Toronto Clinical Neuropathy Score (mTCNS) and randomly allocated into two groups. Group I underwent ultrasound-guided perineural PRP injection and medical treatment, and Group II received medical treatment only. Patients were followed up at months 1, 3, and 6 with regard to pain and numbness visual analog scale (VAS) and mTCNS scores.

RESULTS

Significant improvement was recorded in pain and numbness VAS scale scores in group I vs group II (P ≤ 0.001 during the whole study period for both parameters); at the same time, mTCNS improved in group I in comparison with group II with P = 0.01, 0.001, and <0.001 at months 1, 3, and 6, respectively.

CONCLUSIONS

Perineural PRP injection is an effective therapy for alleviation of diabetic neuropathy pain and numbness and enhancement of peripheral nerve function.

Address: Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt.; Anesthesia, Intensive Care and Pain Department Department, Faculty of Medicine, Assiut University, Assiut, Egypt.; Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt.; Anesthesia, Intensive Care and Pain Department, Faculty of Medicine, Minia University, Minia, Egypt.; Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

DOI: 10.1093/pm/pnz140

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MeSH Terms: Adult, Analgesics, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Female, Glycemic Control, Humans, Hypesthesia, Injections, Male, Median Nerve, Middle Aged, Neural Conduction, Neuralgia, Pain Measurement, Peroneal Nerve, Platelet-Rich Plasma, Pregabalin, Radial Nerve, Selective Serotonin Reuptake Inhibitors, Sural Nerve, Thioctic Acid, Tibial Nerve, Treatment Outcome, Ulnar Nerve, Vitamin B Complex