There is extensive literature and research evidence supporting the use of Cognitive Behavioural Therapy (CBT) in chronic pain cases. In particular it is felt that treatment of depression can help the patient with neuropathic pain to fully enlist in pain management and rehabilitation (Leo, 2006).
There are at least 35 randomised controlled trials demonstrating the effectiveness of CBT for chronic pain (Closs et al, 2007). The psychological effects of pain for patients with chronic pain with and without a neuropathic element is similar insofar as both groups display difficulties in the same areas, including negative affective-motivational, cognitive-evaluative and psychosocial states (Gustin et al, 2011). It is likely that, as these dimension are experience similarly in both groups, a CBT approach which addresses these areas is likely to be similarly effective.
A meta-analysis in 2010 reviewed 14 studies into chronic neuropathic pain in adults and, while the researchers found that no definitive conclusion could be drawn with regards to the efficacy of this approach due to methodological quality problems in the studies, they did find some evidence indicating that it may be a useful intervention. One study of good methodological quality did find a significant effect to the intervention in females, and other studies of poorer methodological quality showed positive effects on pain and quality of life (Wetering et al. 2010).
Most recently a study utilised CBT techniques with 61 clients with chronic neuropathic pain following spinal cord injury. They found that following the intervention decreased pain intensity, pain-related disability, anxiety and led to an increase in participation in activities (Heutink et al. 2011).
In summary, there is good evidence that client’s with chronic pain, including chronic neuropathic pain, would benefit from a course of CBT which focuses on pain management alongside pharmacological interventions for pain.
Leo, R.J. 2006. Treatment Considerations in Neuropathic Pain. Current Treatments in Neurology 8:389-400
Closs, S.J., Staples, V., Reid, I., Bennett, M.I & Briggs, M (2007) Managing symptoms of neuropathic pain: An exploration of patient’s experiences. Journal of Pain and Symptoms Management, Volume 24(4), 422-433
Heutink, M., Post, M.W.M, Bongers-Jansenn, H.M.H., Dijkstra, C.A., Snoek, G.J., Spijkerman, D.C.M., & Linderman, E. The CONECSI trial: Results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury. Pain. 153:1. 120-128
Gustin, S.M., Wilcox, S.L., Peck, C.C., Murray, G.M., Henderson, L.A., Similarity of suffering: Equivalence of psychological and psychosocial factors in neuropathic and non-neuropathic orofacial pain patients. Pain. 152:4. 825-832
Wetering, E.J., Lemmens, K.M.M., Nieboer, A.P., Huijsman, R., 2010. Cognitive and behavioural interventions for the management of chronic neuropathic pain in adults- a Systematic review. European Journal of Pain 14:7. Pages 670-681