Psychologically based interventions for adults with chronic neuropathic pain: a scoping review.

Summary

Psychologically based interventions may help adults with chronic neuropathic pain, but evidence remains limited. A scoping review of 33 articles identified four main approaches: cognitive-behavioral therapy, mindfulness/meditation, trauma-focused therapy, and hypnosis. Only 13 randomized controlled trials were found, and of those, 9 had at least 20 participants per group after treatment. Cognitive-behavioral therapy was the most common approach, while mindfulness/meditation was the most frequently used technique. Nearly half to two-thirds of studies reported significant improvements in pain, disability, or distress, suggesting potential benefit. An updated systematic review appears warranted.

Study at a glance

Abstract

As psychologically based interventions have been shown to have clinical utility for adults with chronic pain generally, a similar benefit might be expected in the management of chronic neuropathic pain (NeuP). However, to date, this has not been established, with existing systematic reviews on this topic being hampered by the scarcity of randomized controlled trials (RCTs). This review aimed to identify the type of psychologically based interventions studied for adults with chronic NeuP. It also aimed to assess whether there are enough RCTs to justify undertaking an updated systematic review. Seven databases and 2 clinical trial registries were searched for NeuP and psychologically based interventions from database inception to December 2021, and the search was updated in February 2023. The search was broadened by reviewing the reference list of included studies and contacting field experts. Predetermined study characteristics were extracted. Of 4682 records screened, 33 articles (less than 1%) met the eligibility criteria. Four broad intervention approaches were observed, including cognitive-behavioral approaches (n = 16), mindfulness/meditation (n = 10), trauma-focused therapy (n = 4), and hypnosis (n = 3). Thirteen RCTs were identified, and of these, 9 retained 20 participants in each arm after treatment. Cognitive-behavioral therapy was the most common therapeutic approach identified, whereas mindfulness/meditation was the most frequently used technique. Almost half to two-thirds of the studies reported significant improvements in pain, disability, or distress, which suggests that psychologically based interventions are potentially beneficial for adults with chronic NeuP. An updated systematic review seems warranted. Open Science Framework (https://osf.io) (December 6, 2021; DOI: 10.17605/OSF.IO/WNSTM).