Description

This session explores therapeutic strategies for painful diabetic neuropathy (PDN), highlighting its prevalence and treatment challenges. First-line medications like pregabalin, gabapentin, and duloxetine often provide limited relief with significant side effects. The talk introduces low-dose naltrexone (LDN) as an off-label option for neuropathic pain, explaining its anti-inflammatory effects and opioid receptor modulation, supported by case reports and small studies. Capsaicin 8% topical patch (Qutenza) is presented as an FDA-approved treatment targeting TRPV1 receptors, offering sustained pain relief for up to three months per application. Finally, high-frequency spinal cord stimulation (SCS) shows superior long-term outcomes for refractory PDN, improving pain, function, and quality of life.