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

Pain Med. 2020 Apr 1;21(4):757-765. doi: 10.1093/pm/pnz140.


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.

Keywords: Diabetic Peripheral Neuropathy; Neuropathic Pain; Platelet-Rich Plasma.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics / therapeutic use
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Neuropathies / etiology
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / therapy*
  • Female
  • Glycemic Control
  • Humans
  • Hypesthesia / etiology
  • Hypesthesia / physiopathology
  • Hypesthesia / therapy*
  • Injections
  • Male
  • Median Nerve
  • Middle Aged
  • Neural Conduction
  • Neuralgia / etiology
  • Neuralgia / physiopathology
  • Neuralgia / therapy*
  • Pain Measurement
  • Peroneal Nerve
  • Platelet-Rich Plasma*
  • Pregabalin / therapeutic use
  • Radial Nerve
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Sural Nerve
  • Thioctic Acid / therapeutic use
  • Tibial Nerve
  • Treatment Outcome
  • Ulnar Nerve
  • Vitamin B Complex / therapeutic use


  • Analgesics
  • Serotonin Uptake Inhibitors
  • Vitamin B Complex
  • Pregabalin
  • Thioctic Acid