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

Mayumi Oguchi; Michael K Nicholas; Ali Asghari; Duncan Sanders; Paul J Wrigley

doi:10.1093/pm/pnae006

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

Pain Med. 2024 May 3;25(6):400-414. doi: 10.1093/pm/pnae006.

Authors

Mayumi Oguchi^{1

2

3}, Michael K Nicholas^{1

2

3}, Ali Asghari^{1

2

3}, Duncan Sanders^{1

2}, Paul J Wrigley^{1

2

3}

Affiliations

¹ Sydney Medical School-Northern, Faculty of Medicine and Health, University of Sydney, 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, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Study registration: Open Science Framework (https://osf.io) (December 6, 2021; DOI: 10.17605/OSF.IO/WNSTM).

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

Publication types

Review

MeSH terms

Adult
Chronic Pain* / psychology
Chronic Pain* / therapy
Cognitive Behavioral Therapy / methods
Humans
Mindfulness / methods
Neuralgia* / psychology
Neuralgia* / therapy
Randomized Controlled Trials as Topic
Systematic Reviews as Topic