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Abstract
Background: Diabetes mellitus is a clinical syndrome characterized by hyperglycemia caused by relative or absolute deficiency of insulin in the body. Painful neuropathy is common in the diabetic population, affecting approximately 50% of patients with chronic diabetes. Objective: The purpose of this study was conducted to investigate the effects of transcranial magnetic stimulation (TMS) versus transcutaneous electrical nerve stimulation (TENS) on neuropathic pain in diabetic patients. Subjects and Methods: Thirty diabetic patients from both sexes with peripheral neuropathy from Outpatient Clinic of Faculty of Physical Therapy, Cairo University and Kaser Al-Aini Hospitals, Cairo University participated in this study. The patients were randomly assigned in two equal groups; group A (TMS group), group B (TENS group). The patient{u2019}s age ranged from 40 to 60 years. group A received TMS in addition to aerobic exercises in the form of stationary bicycle. group B received TENS in addition to the same aerobic exercises as in group A. Both groups received treatment program for five consecutive days for one week. Neuropathic pain intensity was measured by using visual analogue scale (VAS) and blood beta (Ý) endorphin level pre and post treatment program. Results: the results revealed that there was no significant difference between TMS and TENS on VAS but there is significant difference between TMS and TENS on blood Ý-endorphin level that greater improvement in TENS group. Conclusion: Both TMS and TENS were shown to be effective in reducing neuropathic pain in patients with diabetes while TENS has more effect