Spinal cord stimulator ineffective in diabetic pain, any alternative?

Some patients with diabetes and severe pains are in an unfortunate situation. To have diabetes and extreme pain in the feet. Not being able to walk properly and waking up in the middle of the night due to pain.  You become rickety and the pain keeps increasing.

Because the initiators of this website like to ‘walk their talk’ we will elaborate on what we think complementary treatment of chronic pain should look like. The treatment should be clearly measurable, safe and easy to tolerate. Here is a practical example.

The patient speaking below has tried everything. Almost 10 different pain killers, prescribed by different pain specialists. Nothing helped and the pain was unbearable.

Eventually, when nobody could think of another solution, she was sent to the university center in Maastricht to measure and place a spinal cord stimulator. This is quite expensive by the way. It requires actual surgery, which can have a range of consequences, including possibility of complications like infection. At first the stimulator seemed to have effects, but after several years it stopped working. And then you’re stuck with a device in your body, now what?

But first: What is spinal cord stimulation (SCS)?

The center in Maastricht in the Netherlands explains it as follows:

With SCS a stimulation electrode is placed against the backside of the spine. The electrode is connected with a pulse generator, which initiates the desired pulses. The pulses block the transmission of pain stimuli through the nerves. When a significant pain decrease is experienced, the patient can have a permanent device implemented under the skin, which continuously gives these impulses.

Here is the story of our patient, in which case this didn’t work:

Revisions of the spinal cord stimulator didn’t help

Despite 10 revisions of the spinal cord stimulator there were no improvements concerning pain sensations. The pain continued to be severe. And we’re talking about a hundred thousand in medical cost… !!

During revisions of the spinal cord stimulator, all sorts of technical measurements are conducted in the hospital, and the stimulator is adjusted based on those results. This is a time consuming job. Can you imagine going up and down to the hospital 10 times for this and still have no results… ?

After the spinal cord stimulator: a simple and cheap treatment protocol. A lot less pain and no side effects.

When nothing else worked, the patient came to us. Using a simple, cheap and effective treatment protocol we no helped her out of debt… and without side effects! The patient thought it was outrageous that more doctors don’t try simple treatments first, like we did, especially if this treatment proved valuable for hundreds of other patients.

This patient had an expensive spinal cord stimulator installed for electrical stimulation. However, the spinal cord stimulator didn’t work, even after 10 revisions (just calculate the cost of that… it comes to about a hundred thousand euros including everything).

Meanwhile we have published our approach to chronic pain in many international articles. The method is cheap and safe. Practically none of the hundreds of patients we treated with this protocol experienced side effects and many have achieved a pain reduction of over 50%. This proved there is another way.

Innovation in pain treatment

Better pain relief with fewer side effects is possible. Taking risks and expensive interventions will still have their place, but try to decrease the pain first with pain relieving mechanisms that are already present in the body.

The Dutch Institute for Neuropathic Pain proved that pain relief with natural substances without side effects is possible. It’s also possible to use simple topical creams that send pain-relieving substances in to the nerves of the skin. Currently, we have developed a number of these types of pain relieving creams, which we described in the literature below. You can also find articles on natural pain relievers like palmitoylethanolamide (Normast, PeaPure) below.

We believe that in 2013 it is necessary to treat patients with chronic pain with pain relievers that have (almost) no side effects first. Not to immediately grab for the strong stuff that turns people in to zombies, in which case driving a car becomes impossible.

Just use common sense. Use the pain relieving mechanisms that are already available in our bodies, as is the case with substances like PeaPure and alfa-lipoic acid, and calm the nerves of the skin with pain relieving creams. If there are no results, it’s still possible to add a low dose of classical pharmaceutical painkillers like gabapentin, amitriptyline or oxycodone. Research showed that the pain relieving abilities of these substances strongly increase by simultaneously taking a natural pain reliever like PeaPure.

Only in case of insufficient effects the choice should be made to increase the dose or choose for expensive spinal cord stimulators.

However, don’t make these choices before you have tried the pain relieving protocol of the Institute for Neuropathic pain.

  1. Alfa-lipoic acid 100mg 3 times a day (right spinning)
  2. PeaPure 1200mg per day
  3. Vitamin D3 at least 1000 IE
  4. Pain relieving cream, containing for example: amitriptyline, baclofen, ketamine or gabapentin.

The creams we developed can be arranged through a special recipe for every doctor that prescribes them. The doctor only needs to contact us directly.

Neuropathic pain with diabetes: why natural treatment?

We hear from our patients that too often doctors say there’s nothing they can do about it and you have to learn to live with the condition. Over hundreds of patients can now confirm that this is nonsense. Diabetic pain due to neuropathy can definitely be treated, even part of the cause. Our neighbors on the east are way more advanced in this treatment. There is talk about possible causal treatments and the substance they use for diabetes patients with neuropathic pain is alfa-lipoic acid.

Why alfa-lipoic acid? Because research showed that it can reduce pain and improve nerve condition.

Italian and Spanish doctors often subscribe the body’s own substance palmitoylethanolamide. Why? Because this substance decreases the mild chronic inflammation in the nerves with diabetes patients and on top of that also relieves pain. This substance has been available in the Netherland since 2011 as the supplement PeaPure.

On top of that, in counties like Germany and Switzerland they advice more vitamin D3. Why? Because many diabetes patients have too little of this important body’s own hormone in their blood, and this substance also has an anti-inflammatory effect. [1] Vitamin D3 is even used with psoriasis, a chronic skin condition. [2] Vitamin D3 inhibits inflammation via the Toll receptors, which are also found around the cells. [3]

The cocktail of alfa-lipoic acid and vitamin D3 should be used by every diabetes patient with pain in the feet. Why? Because so many patients feel better by using it. You can hear it from our patients themselves on our video channel.

However, alfa-lipoic acid, PeaPure and vitamin D3 are not medicine, but supplements that are not marketed by large pharmaceutical industries. In our opinion, many patients are suffering from diabetes pain and diabetic polyneuropathy unnecessarily because these supplements aren’t pushed. Talk to your doctor about this. On this site and on the sites http://www.neuropathie.nu and http://www.chronicpaincoalition.com you will find all the scientific background around these 3 substances and our creams.

The cocktail of these 3 and the pain relieving creams have no notable side effects and get many patients out of the pain zone!


  1. Keppel Hesselink JM, Kopsky DJ. Letter to the editor. Curr Ther Res Clin Exp2010 71(6): 416-417.
  2. Keppel Hesselink JM, Kopsky DJ. An integrative approach for the treatment of neuropathic pain.EU J Int Med 2010; 2 (4): 190.
  3. Kopsky DJ, Keppel Hesselink JM Nerve Regeneration in Neuropathic PainPain Med 2010 Okt, 11(10):1576.
  4. Kopsky DJ, Keppel Hesselink JM. A new combination cream for the treatment of severe neuropathic pain.J Pain Symptom Manage. 2010 Feb;39(2):e9-e10.
  5. Keppel Hesselink JM, Kopsky DJ. Enhancing acupuncture by low dose naltrexone. Acupunct Med. 2011 Jun;29(2):127-30. Epub 2011 Mar 17. [3]
  6. Liebregts R, Kopsky DJ, Keppel Hesselink JM. Topical amitriptyline in post-traumatic neuropathic pain.J Pain Symptom Manage. 2011 Apr;41(4):e6-7. [4]
  7. Keppel Hesselink JM. Effectiveness of the association micronized N-palmitoylethanolamine (PEA)-transpolydatin in the treatment of chronic pelvic pain. Eur J Obstet Gynecol Reprod Biol. 2011 Jul 14 [5]
  8. David J. Kopsky and Jan M. Keppel Hesselink. Multimodal Stepped Care Approach Involving Topical Analgesics for Severe Intractable Neuropathic Pain in CRPS Type 1: A Case Report. IN: Case Reports in Medicine Volume 2011, Article ID 319750, doi:10.1155/2011/319750
  9. David J. Kopsky, G.J. Amelink and Jan M. Keppel Hesselink. Intractable neuropathic pain in spinal intramedullary cavernoma treated successfully with a novel combination cream.Pain Medicine 2012, accepted for publication



[1] Moghaddami M, Mayrhofer G, Anderson PH, Morris HA, Van Der Hoek M, Cleland LG. |Efficacy and mechanisms of action of vitamin D in experimental polyarthritis. | Immunol Cell Biol.2012 Feb;90(2):168-77. doi: 10.1038/icb.2011.22. Epub 2011 Mar 29.

[2] O’Neill JL, Feldman SR. | Vitamine D analogue-based therapies for psoriasis. | Drugs Today (Barc). | 2010 May;46(5):351-60. doi: 10.1358/dot.2010.46.5.1473264.

[3] Choi B, Lee ES, Sohn S. | Vitamin D3 ameliorates herpes simplex virus-induced Behçet’s disease-like inflammation in a mouse model through down-regulation of Toll-like receptors. | Clin Exp Rheumatol. | 2011 Jul-Aug;29(4 Suppl 67):S13-9. Epub 2011 Sep 27.




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