Non-invasive and Non-pharmacological Methods for the Alleviation of Neuropathic Pain

Background: The difficulties encountered in the alleviation of neuropathic pain raise the need for implementation of methods to reduce pain in non-invasive and non-pharmacological ways, which can be used as complementary and alternative therapies. Aim: To investigate the efficacy of non-invasive and non-pharmacological methods of relieving the pain of neuropathy, and to promote the most appropriate of these methods. Method: A critical review of research articles was made, using the electronic databases Medline, Embase, Cinahl and HEAL-Link, and the Google Scholar (1985-2008), with the key words: Neuropathic pain, alternative therapies, management, non pharmacological, non invasive, rehabilitation. The inclusion criteria were the English language, and the research design, and 33 relevant primary research articles were found, of which 27.3% referred to patients with painful diabetic neuropathy. Results: The mirror and the virtual walking treatment, and the traditional/energy therapies (ice massage, therapeutic touch, reflexology, acupuncture) are all reported to contribute to the alleviation of neuropathic pain, some with strong and sustained effects. Forms of treatment that use light (monochromatic infrared radiation) and radiation (laser), as well as those using electromagnetic energy (treatment with magnetic field, electromagnetic neurostimulation, transcutaneous electrical nerve stimulation, electroacupuncture, electrotherapy, repetitive transcranial magnetic stimulation, vibratory stimulation), also appear to contribute to the relief of neuropathic pain. These forms of therapy have all been studied in depth and their use is widespread. In addition, various self-treatment methods (imagery, cognitive behaviour therapy, sensory discrimination training, application of OpSite dressings) and the lifestyle intervention programme may also produce similar positive results. Conclusions: The currently applied non-invasive and non-pharmacological analgesic methods play a key role in the management of neuropathic pain and can be used as alternative therapy by the nurse. The methods reviewed appear to be effective for the alleviation of the neuropathic pain which compromises the daily routine and quality of life of patients.