The Efficacy of non-pharmacological interventions in improving pain and function in individuals with neuropathic pain: a network meta-analysis of randomised controlled trials

Neuropathic pain, resulting from a lesion or disease of the somatosensory nervous system, is a common and disabling condition for which effective long term management remains challenging. Pharmacological treatments are often limited by modest efficacy and the burden of adverse effects, which restrict their use in many patients. Consequently, a range of non-pharmacological interventions has been investigated as potential alternatives or adjuncts, and a growing number of randomised controlled trials has examined their effects on neuropathic pain. However, the available evidence is fragmented, with most studies evaluating single interventions against control conditions and few direct comparisons between different non-pharmacological approaches. As a result, it remains difficult to determine which interventions are relatively more effective. A network meta-analysis allows the integration of both direct and indirect evidence to compare multiple interventions simultaneously and may help clarify the relative effectiveness of non-pharmacological treatments for neuropathic pain, thereby supporting more informed clinical decision making and future guideline development.