Nonpharmacological Treatment of Neuropathic Pain

Abstract

This chapter discusses various nonpharmacological treatments for neuropathic pain. Physiotherapy, tai chi, and yoga are all methods that incorporate movement exercise to treat biomechanical imbalances and reduce kinesiophobia, or “fear of movement.” Additionally, this chapter discusses treatments targeted at the peripheral nervous system, such as structured graded desensitization, heat/cold physical modalities, transcutaneous electrical nerve stimulation, and acupuncture, all of which have varying levels of efficacy. The chapter reviews the different psychotherapy approaches to treating neuropathic pain: cognitive-behavioral therapy (CBT), operant-behavioral therapy, mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT). It is important to note that many of the therapies discussed are intended to be incorporated with other pharmacological or interventional approaches to provide a multimodal level of care and increase chances of outcome success. Other treatments discussed include orthotics, mirror therapy, and transcranial magnetic stimulation for a variety of neuropathic conditions.