Breakthrough in Diabetic Neuropathy: Nerve Decompression Offers Hope!

DALLAS – March 20, 2024 – Imagine a world where those suffering from diabetic neuropathy could find genuine relief. Thanks to innovative researchers at UT Southwestern Medical Center, surgical nerve decompression—a technique commonly used for conditions like carpal tunnel syndrome and sciatica—might just hold the key to alleviating the pain experienced by countless patients with diabetic neuropathy.

This groundbreaking five-year study, highlighted in the Annals of Surgery, marks a significant milestone as the first randomized control trial investigating the impact of lower extremity nerve decompression surgery on patients grappling with diabetic peripheral neuropathy.

With nearly 20 million Americans affected, diabetic neuropathy is an insidious condition that progressively damages nerves, particularly in the legs and feet. Currently, patients primarily rely on temporary pain-relief medications, which often lose their effectiveness over time, leaving many in despair.

“Living with diabetic neuropathy can be life-altering, severely limiting mobility and diminishing quality of life,” explains Dr. Rozen. “Research indicates that about one-third of these patients experience nerve compression caused by changes in their physiology due to diabetes. Our findings suggest that nerve decompression surgery may provide long-lasting relief by alleviating pressure on these critical nerves.”

Diabetic neuropathy can cause nerve swelling, leading to compression by surrounding tissue, resulting in debilitating pain and muscle weakness. The surgical procedure involves removing this tissue, enhancing blood flow, and consequently alleviating symptoms.

The study enrolled 78 patients at UT Southwestern and Parkland Health, randomly dividing them into two groups: one received the nerve decompression surgery while the other remained on medication. Interestingly, each surgical patient also had a leg selected for a “sham surgery”—where incisions mimic the procedure but lack therapeutic actions—while their other leg underwent the actual decompression.

Patients were kept in the dark about which leg received the sham treatment, and evaluators were blind to the patient groupings, greatly enhancing the reliability of the study’s results. “This level of masking ensures that our findings are robust and credible,” Dr. Rozen adds.

During follow-up visits, patients completed standardized questionnaires assessing pain and lifestyle. Remarkably, after just 12 months, those who underwent surgery reported significantly reduced pain in both legs, while the observation group’s pain levels remained unchanged.

Fast forward to 56 months, and the surgical patients reported even more substantial pain relief, while the observation group experienced escalating discomfort. Unlike the earlier follow-up, it became clear that patients who had their nerves decompressed enjoyed far greater improvement in their treated legs compared to those who underwent sham surgery.

“While the initial year’s pain reduction might suggest a placebo effect, the five-year data indicates that the surgery has a genuinely positive long-term effect,” Dr. Rozen remarked. “There remains an ongoing debate about the role of decompression surgery in treating diabetic neuropathy. This study is a significant step toward enriching the conversation and paving the way for further research to understand how effectively we can offer relief to patients.”

Other brilliant minds contributing to this pivotal study include Steven Vernino, M.D., Ph.D., Professor of Neurology; Philip Raskin, M.D., Professor of Internal Medicine; Linda Hynan, Ph.D., Adjunct Professor in Public Health and Psychiatry; April Gorman, Ph.D., Biostatistician; and Rita Fulmer, M.S.N., APRN, FNP-C, from Physical Medicine & Rehabilitation.

Dr. Vernino, a Distinguished Teaching Professor, also holds prestigious chairs in Neuromuscular Disease Research and Multiple System Atrophy. Dr. Raskin holds a significant role in Biomedical Research as well.

This vital research was made possible by funding from the National Institutes of Health and the David M. Crowley Foundation.

About UT Southwestern Medical Center

UT Southwestern stands tall as one of the nation’s leading academic medical institutions, seamlessly blending pioneering biomedical research with unparalleled clinical care and education. With a faculty that includes six Nobel Prize winners and numerous members of esteemed national academies, UT Southwestern is committed to transforming medical research into cutting-edge treatments. Each year, UT Southwestern’s dedicated physicians provide exceptional care in over 80 specialties, serving more than 120,000 hospitalized patients and overseeing nearly 5 million outpatient visits.

About Parkland Health

Parkland Health is among the largest public hospital systems in the United States, featuring exemplary services at the state-of-the-art Parkland Memorial Hospital. This includes the prestigious Level I Rees-Jones Trauma Center and North Texas’s only burn center accredited for patients of all ages. With a commitment to diversity, inclusion, and health equity, Parkland is dedicated to enriching the health and well-being of the communities it serves. For more information, visit parklandhealth.org.