Non-pharmacological interventions for chronic pain in multiple sclerosis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Pain Management

Background:

• Chronic pain is a significant issue for persons with multiple sclerosis (pwMS).
• Non-pharmacological interventions are commonly used for pain management in pwMS.
• The effectiveness and safety of many non-pharmacological therapies remain unclear.

Purpose of the Study:

• To evaluate the effectiveness and safety of non-pharmacological therapies for chronic pain in pwMS.
• To identify which non-pharmacological interventions are most effective for pain reduction in pwMS.
• To determine the optimal settings for these interventions.

Main Methods:

• A systematic literature search was conducted using specialized databases and trial registries.
• Included studies were randomized controlled trials (RCTs) and cross-over studies.
• Study selection, data extraction, and quality assessment were performed independently by three reviewers.

Main Results:

• Ten RCTs involving 565 participants were included, assessing interventions such as TENS, psychotherapy, tDCS, and reflexology.
• Very low-level evidence supports the use of these non-pharmacological interventions for reducing pain intensity in pwMS.
• Observed improvements in pain scores and secondary outcomes were limited by study methodological biases.

Conclusions:

• Current evidence for non-pharmacological interventions in managing chronic pain in pwMS is limited or insufficient.
• Further research with robust methodology and larger participant numbers is required.
• The efficacy of interventions like TENS, psychotherapy, and reflexology needs more rigorous investigation.