Combination physiotherapy produced modest pain relief in adults with painful DPN associated with T2DM. The analysis, reported in the Journal of Diabetology, evaluated the effects of exercise and electrotherapy on pain, quality of life, and nerve conduction velocity. The review included 10 randomized controlled trials, with nine eligible for pooled analysis. Data were derived from PubMed, Scopus, and PEDro searches up to March 23, 2020.

Exercise combined with electrotherapy reduced pain more effectively than control interventions (odds ratio [OR] 0.59; P = 0.56), although the reduction was not statistically significant. Exercise therapy alone did not significantly improve nerve conduction velocity or quality of life (OR 1.21; P = 0.63). Electrotherapy alone also did not yield a statistically significant improvement in pain or quality of life (OR 0.80; P = 0.70). Heterogeneity across the included studies contributed to uncertainty regarding the overall treatment effect.

These findings suggest that a combination of exercise and electrotherapy may reduce pain in painful DPN, while effects on other functional outcomes remain inconclusive. Well-designed clinical trials are needed to clarify the role of physiotherapy in managing DPN symptoms.