Do you recommend neuromodulation treatments with an implantable device for patients with chronic painful diabetic neuropathy who have not responded to common oral therapies such as Gabapentin and Amitriptyline?

Absolutely.

I am a board-certified neurologist and pain medicine physician. By the time patients are referred to neurology, they have typically failed conservative oral or topical therapies. In this context, spinal cord stimulation represents a transformative option.

Conventional oral medications usually provide only a 10–20% improvement in pain compared with a placebo, whereas randomized controlled trials demonstrate that spinal cord stimulation can achieve 70–80% pain reduction. I routinely perform both trials and permanent implants for this patient population, and my outcomes have been consistent with the published evidence.

Importantly, the trial procedure itself is minimally invasive. Similar in risk profile to an epidural steroid injecti...