Neuropathy +
Pain Relief & Balance™
Reimbursable Neuropathy Program
Embedded Files
#1 Reimbursable NEUROPATHY Program (Small & Large Fibers)
Diabetic Neuropathy + Pain Relief & Balance™
Diabetic neuropathy is one of the most common and devastating complications of diabetes, often leading to chronic pain, falls, ulcers, and amputations if left undetected. The Diabetic Neuropathy + Pain Relief & Balance Program™ was designed to change that. By combining the Diabetic Neuropathy Device™ (DND) for small and large fiber testing, NeuroMed Electroanalgesia Therapy for drug-free pain relief, and Biofeedback Balance Testing and Training for fall risk management, providers gain a turnkey solution that detects earlier, treats sooner, and preserves patient mobility and independence. With CMS billable assessments and reimbursable therapies, this program not only protects patients but also strengthens clinics with sustainable revenue and streamlined workflows.
Temperature (Small Fiber)
Temperature (Small Fiber)
"The Device (DND) Replaces Tuning Forks and Monofilaments..."
"The Device (DND) Replaces Tuning Forks and Monofilaments..."
Kazu Suzuki DPM, Medical Director of the Tower Wound Care Center at the Cedars-Sinai Medical Towers in Los Angeles, CA; Managing Neuropathy And Pain In Wound Care Patients, Podiatry Today; September 2015; 26-27.
Site-Specific Predictive Biomarkers
Site-Specific Predictive Biomarkers
"Every medical practice should test patients with the DND before referring them to a specialist because it can help identify potential underlying conditions that may require further investigation or treatments." -J. Gonzalez MD, Neurologist
Vibration (Large Fiber)
Vibration (Large Fiber)
The NeuroMed is the most advanced Neuropathy treatment Available
The NeuroMed is the most advanced Neuropathy treatment Available
NeuroMed’s Electroanalgesia Therapy is a drug-free, non-surgical treatment for neuropathy pain that goes far beyond traditional TENS.
AI-Enabled Motion Sensors: For in-clinic and at-home therapy.
Neuropathy Assessments & Therapies
Neuropathy Assessments & Therapies
People with diabetes are living longer, healthier lives because of advances in early detection screening and timely intervention. Yet too often, preventable complications still arise simply because the right tools are not being used. Outdated methods like tuning forks (1711) and monofilaments (1938) remain common in exams, but they are subjective and imprecise, missing many cases of neuropathy until it is too late. The result is delayed diagnoses, untreated balance dysfunction, and preventable outcomes such as falls, ulcers, and amputations.
Our Diabetic Neuropathy + Pain Relief & Balance Program™ changes this by bringing together the most advanced tools available today into a single, turnkey solution for providers.
At the cornerstone is the Diabetic Neuropathy Device™ (DND), the only FDA-registered neuropathy tool that delivers two reimbursable tests in under three minutes by measuring both small fiber (temperature) and large fiber (vibration) nerve function. Detecting both types of nerve damage is critical, since large fiber neuropathy often goes unnoticed with conventional testing yet is the leading driver of diabetes-related amputations.
For patients already living with neuropathy pain, we integrate NeuroMed Electroanalgesia Therapy, a proven, drug-free treatment that uses high-frequency electrotherapy to reduce pain, improve function, and restore quality of life without dependence on medications.
The program incorporates Biofeedback Balance Testing and Training, giving providers the ability to assess fall risk and deliver real-time neuromuscular re-education. These sessions can be performed in-clinic for therapy reimbursement or extended at-home through remote biofeedback, ensuring patients continue improving stability and mobility. For patients with diabetes and neuropathy, which heighten fall risk and increase the need for closer evaluation, a cognitive assessment may likely be recommended, particularly for those with a history of falls.
Supporting these core therapies, DTC also integrates AI-powered motion sensors that measure gait symmetry, balance deviation, motor response, and joint mobility in minutes. These precise, objective insights replace guesswork with quantifiable results, enabling providers to identify subtle neuromusculoskeletal issues and launch reimbursable care plans that reduce risks and improve outcomes.
Complementing these therapies, we include NutriNerve® by world renown Dr. Aaron Vinik MD PhD, as an ongoing all-natural antioxidant supplement for all nerves, representing the best that scientific thinking can offer for nerve health, backed by his clinical studies on neuropathy and inclusion in his treatments.
Together, these tools support:
CMS billable assessments and reimbursable diagnostics for neuropathy, fall risk, and gait training
Peripheral neuropathy testing with higher sensitivity than monofilaments or tuning forks
Turnkey diabetes care programs that include both in-clinic and remote therapy
Seamless integration of cognitive assessments, PAD screening, and cardiovascular risk evaluation
Unlike outdated methods, these systems deliver repeatable, quantifiable results and real-time feedback to guide therapy, improving outcomes while strengthening provider efficiency and revenue.
At Diabetes Testing Centers™ (DTC), we have built these technologies into our turnkey Chronic Care Programs® because they represent not just an upgrade, but the future of preventive medicine. Our goal is to help providers detect, treat, and manage neuropathy earlier, preserve patient mobility and independence, and keep care and revenue in-house. Every provider should have access to these tools—because every patient deserves better outcomes and more years without preventable complications.
Diabetic Neuropathy Accounts for More Hospitalizations Than All Other Diabetic Complications Combined...
Aaron Vinik, MD, Ph.D., Endocrinologist, Diabetic Neuropathies, February 5, 2018
Do you want to improve your patient services but lack the financial resources to get started? Click here to discuss potential collaborations and opportunities.
The Best Supplement that Scientific Thinking Can Offer for Nerve Health.
by Dr. Aaron Vinik MD PhD
People with diabetes are living longer and healthier lives with fewer complications because of technological advances, earlier interventions, and, in some cases, all-natural supplements like Dr. A. Vinik MD PhD nerve health supplements.
NutriNerve® is a proprietary formula created by the renowned Endocrinologist Dr. Aaron Vinik MD PhD. After many decades of scientific research in diabetic neuropathy, Dr. Vinik demonstrated that damaged nerves may be regenerated with the proper nutrients.
Click HERE for professional pricing.
Clinical References (use dropdown)
Rolke R, Magerl W, Campbell KA, et al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain. 2006; 123(3):231-243.
M.Backonja. Challenges and opportunities for neuropathic pain evaluation in a primary care setting. Third International Congress on Neuropathic Pain. Athens, Greece. 2010:18. Personal communication.
M.Ware. Standardizing the clinical sensory examination. Third International Congress on Neuropathic Pain. Athens, Greece. 2010:18. Personal communication.
G. Mick. Basis for a simple clinical sensory examination in non-specialized practice. Third International Congress on Neuropathic Pain. Athens, Greece. 2010:18. Personal communication.
Boulton AJ,Vinik AI, Arezzo JC, et al. Diabetic neuropathies: a statement by American Diabetes Association. Diabetes Care 2005; 28:956.
http://uptodateonline.com/online/content/topic.do?key=neuropat
Petr Boucek Advanced Diabetic Neuropathy: A Point of no Return? Rev Diabet Stud, 2006, 3(3):143-150.
M. Bharara, MsC, j.e. Cobb, PhD, CEng, and D.J. Claremont, MSc, DPhil, FIPEM
Thermography and Thermometry in the Assessment of Diabetic Neuropathic Foot: A Case for Furthering the Role of Thermal Techniques. Int J Low Extem Wound5(4); 2006pp. 250-260.
Dworkin, RH., editor. Recommendations for the definition, assessment, and pharmacologic management of neuropathic pain. Am J Medicine. 2009; 122:10A (suppl): S1-S31.
Treede RD, Jensen TS, Campbell JN, et. Neuropathic pain: redefinition and a grading system for clinical research purposes. Neurology. 2008; 70: 1630-1635.
National Institute of Health. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/.
Bouhassira D, Lanteri-Minet M, Attal N, et al. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain. 2008; 136(3):380-387.
Kanji JN, Anglin RE, Hunt DI., et al. JAMA 2010;303(15):1526-1532
Valk, GD,Grootenhuis J TH, Bouter LM., et al. Methods for assessing diabetic polyneuropathy:validity and reproducibility of the measurement of sensory symptom severity and nerve tests. Diabetes research and Clinical practice 2000: 47;87-95.
Vinik AI, Bril V, Litchy WJ, Price KL, Bastyr EJ. Sural sensory action potential identifies diabetic peripheral neuropathy responders to therapy. MBBQ Study Group. Muscle Nerve 2005. 32:619-625 .
DCCT Research Group. The effect of intensive diabetes therapy on the development and progression of neuropathy. Ann Int Med 1995. 122(8):561-568.
Jensen MP, Chodroff MJ, Dworkin RH. The impact of neuropathic on health-related quality of life: review and implications. Neurology 20007;68(15):1178-1182.
Dworkin RH, O’Connor AB, Audette J, et al. Recommendation for the pharmacological management of neuropathic pain: an overview and literature update. Update on guidelines for the treatment of neuropathic pain, including consideration for special population. Mayo Clin Proc. 2010; 85 (3) (suppl): S3-S14.
http://www.disabled-world.com/health/diabetes/diabetic-foot-ulcers.php
http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf Centers for Disease Control and Prevention, National Diabetes Fact Sheet, 2011
Guy RJC, Clark CA, Malcolm PN, Watkins PJ: Evaluation of thermal and vibration sensation in diabetic neuropathy. Diabetologia 28: 131–137, 1985.
Vinik AI, Erbas T, Stansberry KB, et al. Small fiber neuropathy and neurovascular disturbances in diabetes mellitus. Exp Clin Endocrinol Diabetes. 2001;109:451–73
Katims JJ. Electrodiagnostic functional sensory evaluation of the patient with pain: A review of the neuroselective current perception threshold (CPT) and pain tolerance threshold (PTT). Pain Digest. 1998;8:219–30.
Archer AG, Watkins PJ, Thomas PK, Sharma AK, Payan J The natural history of acute painful neuropathy in diabetes mellitus. J Neurol Neurosurg Psychiatry 1983 46: 491–499
Dyck PJ, Zimmerman IR, O'Brien PC, Ness A, Caskey PE, Karnes J, Bushek W) Introduction of automated systems to evaluate touch-pressure, vibration, and thermal cutaneous sensation in man. Ann Neurol 1983 4: 502–510
Fruhstorfer H, Lindblom U, Schmidt WG) Method for quantitive estimation of thermal thresholds in patients. J Neurol Neurosurg Psychiatry 1976 39: 1071–1075
Fagius J, Wahren LK) Variability of sensory threshold determinations in clinical use. J Neurol Sci 1981 51: 11–27
Bloom S, Till S, Sönksen P, Smith S) Use of a biothesiometer to measure individual vibration thresholds and their variation in 519 non-diabetic subjects. Br Med J 1984 288: 1793–1795
Bergström B, Rosberg K, Sundkvist G Autonomic nerve function tests. Reference values in healthy subjects. Clin Physiol 1986 6:523–528
Scott AR, MacDonald IA, Bennett T, Tattersall RB) Abnormal thermoregulation in diabetic autonomic neuropathy. Diabetes 3 1988 7:961–968
Vinik AI, Erbas T, Stansberry KB, et al. Small fiber neuropathy and neurovascular disturbances in diabetes mellitus. Exp Clin Endocrinol Diabetes. 2001;109:451–73
Ohta Akio, Obi Ryusei, Kawata Takehiro, et al. The cold-loaded pain sensation test in the diagnosis of diabetic neuropathy. Jpn J Clin Physiol. 2006;36:47–55.
Masson EA, Boulton AJM. The neurometer: validation and comparison with conventional tests for diabetic neuropathy. Diabetic Med. 1991;8:s63–6
Pitei DL, Watkins PJ, Stevens MJ, et al. The value of the neurometer in assessing diabetic neuropathy by measurement of the current perception threshold. Diabetic Med. 1994;11:872–6.
Suzuki K, Chung Y, Kobayashi Y, et al. Current perception thresholds: a new method for assessment of peripheral sensory neuropathy in diabetes mellitus. Peripheral Nerve. 1995;6:59–63.
Parkhouse N, LeQueen PM. Impaired neurogenic vascular response in patients with diabetes and neuropathic foot lesions. N Engl J Med 1988;318:1306–1309
Stevens MJ, Feldman EL, Greene DA. The aetiology of diabetic neuropathy: the combined roles of metabolic and vascular defects. Diabet Med. 1995;12:566–579
Booya F, Bandarian F, Larijani B, Pajouhi M, Nooraei M, Lotfi J: Potential risk factors for diabetic neuropathy: a case control study. BMC Neurol 2005,10(5):24
Pajouhi M, Shaban Nejad Khas Z, Mohajeri Tehrani M: Evaluation and prevention of diabetic neuropathy (review article). TUMJ2007,65(3):1–6.
Birke J, Rolfsen R: Evaluation of a self-administered sensory testing tool to identify patients at risk of diabetes-related foot. Diab Care1998, 21:23–25
Litzelman D, Marriott D, Vinicor F: Independent physiological predictors of foot lesions in patients with NIDDM. Diab Care 1997, 20:1273–1278
Olaleye D, Perkins BA, Bril V: Evaluation of three screening tests and a risk assessment model for diagnosing peripheral neuropathy in the diabetes clinic. Diab Res Clin Prac 2001,54(2):115–128
Nather A, Neo S, Chionh S, Liew S, Sim E, Chew J: Assessment of sensory neuropathy in diabetic patients without diabetic foot problems. J Diabetes Complications 2008,22(2):126–131 Abbott AL, Carrington H, Ashe S, Bath LC, Every J, Griffiths ER, Van Ross AJM: Boulton, North–west diabetes foot care study: incidence of and risk factors for new diabetic foot ulceration in a community-based study. Diab Med 2002, 19:377–384.
Forouzandeh F, Aziz Ahari A, Abolhasani F, Larijani B: Comparison of different screening tests for detecting diabetic foot neuropathy.Acta Neurologica Scandinavica 2005,112(6):409–413.
Dimitrakoudis D, Bril V: Comparison of sensory testing on different toe surfaces: implications for neuropathy screening. Neurology2002,59(4):611–613
Armstrong DG1, Lavery LA, Vela SA, Quebedeaux TL, Fleischli JG.Arch Intern Med. 1998 Feb 9;158(3):289-92.Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration.
Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial.Pham H1.Diabetes Care. 2000 May;23(5):606-11.
Sharonjeet Kaur,1 Promila Pandhi,1 and Pinaki Dutta, DM2Painful diabetic neuropathy: an update.,*Ann Neurosci. 2011 Oct; 18(4): 168–175. 10.5214/ans.0972-7531.1118409
Sharonjeet Kaur,1 Promila Pandhi,1 and Pinaki Dutta, DM2 Predicted costs and outcomes from reduced vibration detection in people with diabetes in the U.S. Sharonjeet Kaur,1 Promila Pandhi,1 and Pinaki Dutta, DM22003 Aug;26(8):2305-10.
Sharonjeet Kaur,1 Promila Pandhi,1 and Pinaki Dutta, DM2 Cost-effectiveness of prevention and treatment of the diabetic foot: a Markov analysis. Sharonjeet Kaur,1 Promila Pandhi,1 and Pinaki Dutta, DM2
Sharonjeet Kaur,1 Promila Pandhi,1 and Pinaki Dutta, DM2 Risk factors for foot ulceration in adults with end-stage renal disease on dialysis: study protocol for a prospective observational cohort study. 2015 Sep 18;8:53. doi: 10.1186/s13047-015-0110-9. eCollection 2015. The Thermal Sensitivity Test in Evaluating Outcome after Peripheral Nerve Injury .Biomed Res Int. 2015; 2015: 528356.Published online 2015 Jun 23.
Sharonjeet Kaur,1 Promila Pandhi,1 and Pinaki Dutta, DM2 New diagnostic tests for diabetic distal symmetric polyneuropathy. 2011 Jan-Feb;25(1):44-51.
Arezzo JC, Schaumburg HH, Laudadio C Thermal sensitivity tester. Device for quantitative assessment of thermal sense in diabetic neuropathy.1986 Diabetes 35:590–592.
Bertelsmann FW, Heimans JJ, Weber EJ, van der Veen EA, Schouten JA Thermal discrimination thresholds in normal subjects and in patients with diabetic neuropathy. J Neurol Neurosurg Psychiatry.1985 48:686–690.
Claus D, Hilz MJ, Neundorfer Thermal discrimination thresholds: a comparison of different methods. Acta Neurol Scan B.1990 81:533–540.
Harding LM, Loescher AR Adaptation to warming but not cooling at slow rates of stimulus change in thermal threshold measurements. 2005 Somatosens Mot Res 22:45–48.
Hoitsma E, Reulen JP, de Baets M, Drent M, Spaans F, Faber CG . Small fiber neuropathy: a common and important clinical disorder. J Neurol Sci 2004 227:119–130.
Ijff GA, Bertelsmann FW, Nauta JJ, Heimans JJ Cold and warm cutaneous sensation in diabetic patients. Diabet Med 1991:8:S71–73.
Kenshalo DR, Bergen). A device to measure cutaneous temperature sensitivity in humans and subhuman species. J Appl Physiol DC 1975: 39:1038–1040.
Lin YH, Hsieh SC, Chao CC, Chang YC, Hsieh ST . Influence of aging on thermal and vibratory thresholds of quantitative sensory testing. J Peripher Nerv Syst 2005 10:269–281.
Maser RE, Nielsen VK, Bass EB, Manjoo Q, Dorman JS, Kelsey SF, Becker DJ, Orchard TJ (). Measuring diabetic neuropathy. Assessment and comparison of clinical examination and quantitative sensory testing. Diabetes Care 1989 12:270–275.
Palmer ST, Martin DJ, Steedman WM, Ravey J C- and Adelta-fibre mediated thermal perception: response to rate of temperature change using method of limits. Somatosens Mot Res 2000 17:325–333.
Yarnitsky D, Sprecher Thermal testing: normative data and repeatability for various test algorithms. J Neurol Sci E 1994. 125:39–45.
Thermal discrimination and Weber's law: with a theory on the nature and function of sensory adaptation. Culler, E. A.Archives of Psychology, Vol 13, 81, 1926, . Sense of Touch and Common Feeling. E.H.Weber 1846
Golosarsky B. Can Heart Rate Variability timing reflect the body stress? 2006 Medical Hypothesis, V. 67, 1467-146
Golosarsky B. Making Neuropathy Screening exam Truly Comprehensive in 5 minutes. Profiles in Excellence. Podiatry Management, 2015 January 155-156
Golosarsky B., et al. 2013 U.S. Patent 8,579,830 Neuropathy Diagnostic Device.
Golosarsky, B., et al. Patent Office, Japan 2011-518739 Neuropathy Diagnostic Device.
Bakkers M1, Faber CG, Peters MJ, Reulen JP, Franssen H, Fischer TZ, Merkies IS Temperature threshold testing: a systematic review. J Peripher Nerv Syst. 2013 Mar;18(1):7-18
Metin Yavuz M, D.Eng, D.G. Armstrong , DPM, MD, PhD, et al; Temperature as a Causative Factor in Diabetic Foot Ulceration: A Call to Revisit Ulcer Pathomechanics; Journal of the American Podiatric Medical Association 2018
Better Options
Better Options
Page updated
Report abuse