Psychologically-based interventions for adults with chronic neuropathic pain: A scoping review

Author: M Oguchi1,2,3, M K Nicholas1,2,3, A Asghari1,2,3, D Sanders1,2, P J Wrigley1,2,3
1 Sydney Medical School-Northern, Faculty of Medicine and Health, University of Sydney, Australia, St Leonards, NSW, 2065, Australia.
2 Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District and the Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia.
3 Pain Management and Research Centre, Douglas Building, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
Conference/Journal: Pain Med
Date published: 2024 Feb 4
Other: Pages: pnae006 , Special Notes: doi: 10.1093/pm/pnae006. , Word Count: 251

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 Randomised 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 two 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 (less than 1%) articles met the eligibility criteria. Four broad intervention approaches were observed, including cognitive-behavioural approaches (n = 16), mindfulness/meditation (n = 10), trauma focused therapy (n = 4), and hypnosis (n = 3). Thirteen RCTs were identified, and of these, nine retained 20 participants in each arm at post-treatment.

Cognitive Behavioural 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 either pain, disability, or distress, suggesting psychologically-based interventions are potentially beneficial for adults with chronic NeuP. An updated systematic review seems warranted.

Keywords: Scoping review; biopsychosocial perspective; chronic pain; neuropathic pain; psychological intervention.

PMID: 38310361 DOI: 10.1093/pm/pnae006