Non-pharmacological interventions for chronic pain in multiple sclerosis

Amatya, Bhasker; Young, Jamie; Khan, Fary

doi:10.1002/14651858.cd012622.pub2

Cited by 48 publications

(41 citation statements)

References 104 publications

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“…Regarding neuromodulation in MS-related NP, the following techniques seem to have promising effects: intrathecal baclofen, functional electrical stimulation, DBS, and spinal cord stimulation [72]. Regarding nonpharmacological interventions, including TENS, psychotherapy (e.g., telephone self-management or hypnosis), transcranial random noise stimulation, transcranial direct current stimulation (tDCS), hydrotherapy, and reflexology, there is at present a very low level of evidence to support their use in patients with chronic MS-related NP, based on a recent Cochrane meta-analysis [73].…”

Section: Chronic Central Npmentioning

confidence: 99%

Therapeutic Approaches for Peripheral and Central Neuropathic Pain

et al. 2019

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Neuropathic pain is a chronic secondary pain condition, which is a consequence of peripheral or central nervous (somatosensory) system lesions or diseases. It is a devastating condition, which affects around 7% of the general population. Numerous etiological factors contribute to the development of chronic neuropathic pain. It can originate from the peripheral part of the nervous system such as in the case of trigeminal or postherpetic neuralgia, peripheral nerve injury, painful polyneuropathies, or radiculopathies. Central chronic neuropathic pain can develop as a result of spinal cord or brain injury, stroke, or multiple sclerosis. As first-line pharmacological treatment options, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and gabapentinoids are recommended. In trigeminal neuralgia, carbamazepine and oxcarbazepine are the first-choice drugs. In drug-refractory cases, interventional, physical, and psychological therapies are available. This review was structured based on a PubMed search of papers published in the field from 2010 until May 2019.

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Section: Chronic Central Npmentioning

confidence: 99%

Therapeutic Approaches for Peripheral and Central Neuropathic Pain

et al. 2019

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“…It can be also used to address a large number of clinical conditions at both acute and chronic stages of disease expression, ranging from treatment of phobias and affective disorders (e.g., depression or posttraumatic stress disorder) to neuropsychiatric disorders, such as dissociative identity disorder, psychosis, anorexia nervosa, and somatic symptom disorder (Lynn et al, 2010). As an alternative approach for multiple medical conditions, hypnosis has also a well-established evidence of treating and managing a spectrum of painful conditions (Vanhaudenhuyse et al, 2015(Vanhaudenhuyse et al, , 2018, such as dilation and curettage (Fathi et al, 2017), irritable bowel syndrome (Gonsalkorale et al, 2003;Surdea-Blaga et al, 2016), phantom limb (Oakley and Halligan, 2002), migraine (Flynn, 2018), cancer-related pain (Vickers and Cassileth, 2001;Carlson et al, 2018), and pain related to multiple sclerosis (Amatya et al, 2018). A common denominator for these interventions is the involvement of the cingulate cortex (Vogt and Brent, 2009).…”

Section: The Merits Of Hypnosis In Clinical Applicationsmentioning

confidence: 99%

Hypnosis for cingulate-mediated analgesia and disease treatment

Trujillo-Rodriguez

Faymonville

Vanhaudenhuyse

et al. 2019

Handbook of Clinical Neurology

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Hypnosis is a technique that induces changes in perceptual experience through response to specific suggestions. By means of functional neuroimaging, a large body of clinical and experimental studies has shown that hypnotic processes modify internal (self-awareness) as well as external (environmental awareness) brain networks. Objective quantifications of this kind permit the characterization of cerebral changes after hypnotic induction and its uses in the clinical setting. Hypnosedation is one such application, as it combines hypnosis with local anesthesia in patients undergoing surgery. The power of this technique lies in the avoidance of general anesthesia and its potential complications that emerge during and after surgery. Hypnosedation is associated with improved intraoperative comfort and reduced perioperative anxiety and pain. It ensures a faster recovery of the patient and diminishes the intraoperative requirements for sedative or analgesic drugs. Mechanisms underlying the modulation of pain perception under hypnotic conditions involve cortical and subcortical areas, mainly the anterior cingulate and prefrontal cortices as well as the basal ganglia and thalami. In that respect, hypnosis-induced analgesia is an effective and highly costeffective alternative to sedation during surgery and symptom management.

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“…This limitation is frequently reported in other systematic reviews regarding vestibular rehabilitation interventions [34,35]. Third, different types of multiple sclerosis were included; however, as in the present review, it is frequent for non-pharmacological interventions to establish inclusion criteria based on disability related to multiple sclerosis instead of the subtype of the disease [38,39]. Fourth, only two studies analysed the presence of brainstem/cerebellar involvement based on magnetic resonance imaging scans and neurologic examinations [27,28], and only one of them contrasted the results taking this condition into account [28].…”

Section: Study Limitationsmentioning

confidence: 85%

Effectiveness of Vestibular Training for Balance and Dizziness Rehabilitation in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

García-Muñoz¹,

Cortés-Vega

Heredia-Rizo

et al. 2020

JCM

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Postural instability and dizziness are commonly observed in people with multiple sclerosis (PwMS). The aim of this systematic review was to evaluate the evidence for the use of vestibular rehabilitation, in comparison with other exercise interventions or no intervention, to treat balance impairments and dizziness in PwMS. An electronic search was conducted by two independent reviewers in the following databases: MEDLINE (Pubmed), Scopus, the Physiotherapy Evidence Database (PEDro), Web of Science (WOS), Lilacs, CINHAL and the Cochrane Database of Systematic Reviews (CDSR). A quality assessment was performed using the PEDro scale and the Cochrane Risk of Bias Tool. When possible, the data were pooled in a meta-analysis (95%CI). This systematic review followed the PRISMA guideline statement and was registered in the PROSPERO database (CRD42019134230). Seven studies were included, with a total of 321 participants analysed. Compared with no intervention, vestibular rehabilitation was more effective for balance development (SMD = 2.12; 95% CI = 0.49, 3.75; p = 0.01; I2 = 89%) and dizziness symptoms improvement (SMD = −17.43; 95% CI = −29.99, −4.87; p= 0.007; I2= 66%). Compared with other exercise interventions, improvements in favour of the experimental group were observed, but statistical significance for the differences between groups was not reached.

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Non-pharmacological interventions for chronic pain in multiple sclerosis

Cited by 48 publications

References 104 publications

Therapeutic Approaches for Peripheral and Central Neuropathic Pain

Therapeutic Approaches for Peripheral and Central Neuropathic Pain

Hypnosis for cingulate-mediated analgesia and disease treatment

Effectiveness of Vestibular Training for Balance and Dizziness Rehabilitation in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

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