Heart Health Articles

AANEM Joint Guideline Documents Scientific Best Practice

July 27, 2017

The American Association of Neuromuscular & and Electrodiagnostic Medicine (AANEM), in collaboration with the American Academy of Neurology (AAN) and the American Academy of Physical Medicine and Rehabilitation (AAPMR), released a new guideline on the most effective treatments for diabetic nerve pain, the burning or tingling pain in the hands and feet that affects millions of people with diabetes.

The guideline is published in the April 2011, online issue of Muscle & Nerve, the medical journal of AANEM, and will be included in the June print issue.

Diabetic nerve pain (DNP), or neuropathy, is caused by nerve damage and presents ongoing management problems for patients, caregivers, and physicians.

John England, MD, AANEM member, guideline co-author, and Professor and Head, Department of Neurology at LSUHSC School of Medicine, said, "Diabetic nerve pain affects at least 4 million people living with diabetes in the United States. Because DNP is a chronic disorder, it's important to begin treating it early and aggressively to maintain a comfortable and manageable lifestyle."

In The Evidence Based Guideline: Treatment of Painful Diabetic Neuropathy, strong evidence shows the seizure drug pregabalin is effective in treating diabetic nerve pain and can improve quality of life. Doctors, however, should determine if it is appropriate for their patients on a case-by-case basis.

In addition, the guideline notes that several other treatment options are probably effective and should be considered. These options include the seizure drugs gabapentin and valproate; antidepressants, such as venlafaxine, duloxetine and amitriptyline; and painkillers, such as opioids and capsaicin. Transcutaneous electric nerve stimulation (TENS), a widely used pain therapy involving a portable device, also was found to be probably effective for treating diabetic nerve pain.

Lead guideline author, Vera Bril, MD, FRCP, with the University of Toronto and an AANEM member, said, "We were pleased to see that so many of these pain treatments had high-quality studies that support their use. Still, it is important that more research be done to show how well these treatments can be tolerated over time."

The release of this guideline means that the entire healthcare community now has access to a document that summarizes how to best treat DNP.

"The collaborative efforts between the AANEM, the American Academy of Neurology and the American Academy of Physical Medicine and Rehabilitation has made this possible," said England.

The guideline also will be published in the April 11, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology, and PM&R, the AAPMR's scientific journal.

Source: American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM)