Complementary therapies for neuropathic and neuralgic pain: systematic review.

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Clin J Pain. 2008 Oct;24(8):731-3.

Complementary therapies for neuropathic and neuralgic pain:

systematic review.

Pittler MH, Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of

Exeter and Plymouth, Exeter, UK.

OBJECTIVE: To assess the evidence from rigorous clinical trials,

systematic reviews, and meta-analyses of complementary and

alternative therapies for treating neuropathic and neuralgic pain.

METHODS: Systematic searches were carried out in the databases

Medline, Embase, Amed, Scopus, the Cochrane Database of Systematic

Reviews, Natural Standard, and the Natural Medicines Comprehensive

Database. Each database was searched from its respective inception

until March 2006. To be included, trials were required to state that

they were randomized. Systematic reviews and meta-analyses were

included if based on the results of randomized trials. No language

restrictions were imposed.

RESULTS: Five relevant systematic reviews and meta-analyses and 15

additional trials met the inclusion criteria and were reviewed. Data

on the following complementary and alternative medicine treatments

were identified: acupuncture, electrostimulation, herbal medicine,

magnets, dietary supplements, imagery, and spiritual healing.

CONCLUSIONS: On the basis of our findings, the evidence is not fully

convincing for most complementary and alternative medicine modalities

in relieving neuropathic or neuralgic pain. However, for topically

applied capsaicin there is evidence of effectiveness beyond placebo.

The evidence can be classified as encouraging and warrants further

study for cannabis extract, magnets, carnitine, and

electrostimulation.