Herbal Interventions for the Management of Painful Diabetic Neuropathy: A Systematic Review

Abstract

Introduction: Painful diabetic neuropathy (PDN) is a common and debilitating complication of diabetes with limited effective treatments. This review evaluates the evidence for herbal medicines in managing neuropathic pain.

Methods: A systematic search was conducted for RCTs comparing herbal interventions to placebo for the treatment of PDN. The primary outcome was a change in pain scores as measured by a visual analog scale (VAS) or similar instruments.

Results: The review included 15 RCTs evaluating agents such as Alpha-lipoic acid (ALA), capsaicin cream, and Ginkgo biloba. Intravenous ALA showed the most robust evidence for reducing neuropathic pain and symptoms. Topical capsaicin also demonstrated significant pain relief, though local side effects were common.

Discussion: Certain evidence-based herbal and plant-derived interventions can be effective in managing PDN. ALA, in particular, addresses both symptoms and underlying pathogenic mechanisms.

Conclusion: Alpha-lipoic acid and topical capsaicin are effective interventions for the symptomatic treatment of painful diabetic neuropathy.