What non-pharmacological interventions are effective for managing neuropathic pain in patients?

Effective non-pharmacological interventions for managing neuropathic pain include:

• Transcutaneous Electrical Nerve Stimulation (TENS): SIGN recommends considering TENS (either low or high frequency) for relief of chronic pain, including neuropathic pain, as it has shown positive analgesic outcomes with minimal differences between frequencies. TENS has been found to reduce pain intensity in peripheral diabetic neuropathy and neck pain, although evidence is limited and conflicting for some conditions ¹,³,⁴.
• Cognitive Behavioural Therapy (CBT): NICE recommends psychological therapies such as CBT for neuropathic pain management, particularly when pain is severe or significantly limits daily activities. CBT may be offered through specialist pain services and has been specifically recommended for neuropathic pain associated with sciatica ³,⁴,⁵.
• Physical and Psychological Therapies via Rehabilitation Services: Non-pharmacological treatments including physical therapies and psychological therapies may be offered through rehabilitation services to complement pharmacological treatments and support self-management ²,⁵.
• Referral to Specialist Pain Services: For patients with severe or refractory neuropathic pain, referral to specialist pain clinics can provide access to additional non-pharmacological options such as nerve blocks, injections, stimulation therapies, and psychological interventions ³,⁴,⁵.
• Self-Management Strategies: Encouraged from early stages through long-term management, self-management can complement other therapies and improve coping with neuropathic pain ¹.