Are circulation booster devices, such as Revitiv, safe and effective for managing neuropathy symptoms?

Circulation Booster Devices for Neuropathy: Not Recommended

I do not recommend circulation booster devices like Revitiv for treating neuropathy, as there is no evidence supporting their effectiveness, and they are not mentioned in any established clinical guidelines for neuropathy management. 1, 2

Why These Devices Are Not Supported

The major clinical guidelines for neuropathy management—including those from the American Diabetes Association, American Society of Clinical Oncology, and American College of Physicians—make no mention of circulation booster devices or electrical foot stimulation devices as treatment options for any form of peripheral neuropathy. 1, 2

The absence of these devices from evidence-based guidelines is significant, as these guidelines comprehensively reviewed all available interventions and specifically evaluated non-pharmacologic approaches. 1

The Circulation Misconception

While older research from 1984 showed that diabetic neuropathy patients actually have increased blood flow (approximately 5 times normal) rather than decreased circulation, this finding contradicts the marketing premise of "circulation boosters." 3 The problem in neuropathy is nerve damage, not poor circulation in most cases. 4

Evidence-Based Alternatives You Should Consider

First-Line Pharmacologic Options

• Duloxetine (60-120 mg/day): FDA-approved with strong evidence (NNT 4.9-5.2) 2, 4, 5
• Pregabalin (300-600 mg/day): FDA-approved with strong evidence (NNT 4.04-5.99) 2, 4, 5
• Gabapentin (900-3600 mg/day): Effective but requires more frequent dosing 2, 4, 5

Non-Pharmacologic Interventions With Actual Evidence

• Exercise and physical activity: Moderate-quality evidence shows benefit for reducing neuropathic symptoms 2, 5, 6
• Transcutaneous electrical nerve stimulation (TENS): Modest benefits, well-tolerated, and inexpensive—but this is peripheral nerve stimulation, not "circulation boosting" 5
• Glycemic control optimization: The foundational intervention for diabetic neuropathy (target HbA1c 6-7%) 1, 2, 5

Interventions Requiring More Research

The American Society of Clinical Oncology specifically states that no recommendations can be made for acupuncture, cryotherapy, or compression therapy outside of clinical trials due to insufficient evidence. 1 If these interventions with some preliminary data cannot be recommended, circulation boosters with zero supporting evidence certainly cannot be endorsed.

Important Safety Considerations

For patients with diabetes and neuropathy, there are specific risks:

• Reduced sensation in the feet means patients may not feel if a device is causing tissue damage 1
• Electrical stimulation devices could potentially cause burns or skin breakdown in patients with impaired sensation 1
• These devices may delay patients from seeking evidence-based treatments that actually work 2, 4

What You Should Do Instead

Start with proven interventions:

1. Optimize blood sugar control if diabetic (HbA1c 6-7%) 1, 2
2. Check for and correct vitamin B12 deficiency 4, 5
3. Control blood pressure and lipids 1
4. Begin first-line medication (duloxetine or pregabalin) if pain is present 2, 4, 5
5. Implement regular exercise program 2, 5, 6

The bottom line: Save your money. Invest instead in evidence-based treatments that have been rigorously studied and proven effective in multiple clinical trials. 2, 4, 5