Rehabilitation interventions for neuropathic pain: a systematic review and meta-analysis of randomized controlled trials
DOI:
https://doi.org/10.2340/jrm.v56.40188Keywords:
chronic pain, interdisciplinary, multimodal, neuropathic pain, outcome, rehabilitationAbstract
Objective: Rehabilitation interventions for chronic pain typically include education, cognitive behavioural therapy, and exercise therapy, or a combination of these. A systematic review and meta-analysis of rehabilitation interventions for neuropathic pain was conducted.
Design: Randomized controlled trials were identified in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and PsycINFO databases from inception up to 3 March 2022.
Subjects/Patients: Adults with chronic (> 3 months) neuropathic pain.
Methods: Primary outcomes were pain intensity, pain-related disability, and work participation. Secondary outcomes were quality of life, emotional strain, insomnia, and adverse outcomes, according to VAPAIN guidelines. Analyses were made post-intervention, which was defined as the assessment point immediately following the intervention or at the first-time measurement conducted after the intervention period.
Results: In total, 15 studies (total population, n = 764) were incorporated. Most common interventions were cognitive behavioural programmes including acceptance and commitment therapy (n = 4), mindfulness-based interventions (n = 5), and yoga (n = 2). Psychological interventions reduced both pain intensity (SMD –0.49, 95% CI –0.88 to –0.10) and pain-related disability (SMD –0.51, 95% CI –0.98 to –0.03), whereas other interventions had an effect on pain intensity but not on pain-related disability.
Conclusion: Rehabilitation interventions, and psychological interventions in particular, seem to be of value for patients with chronic neuropathic pain.
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