Physiotherapy improves neuropathic pain biomarker profile

Physiotherapeutic interventions, like exercise therapy and electro-acupuncture, appear to be effective at reducing the expression of neuropathic pain biomarkers, reveals a new systematic review.

“Whereas the results seem promising, they have to be considered with caution due to the high risk of bias of included studies and high heterogeneity of the type and anatomical localization of biomarkers reported,” the researchers said.

Drawing from the online databases of Embase, Web of Science, PubMed, Cochrane, Cinhal, Medline, Science Direct, Psycinfo, and Scopus, researchers conducted a literature review of studies assessing any type of physiotherapy for systemic or traumatic peripheral neuropathic pain. Ultimately, 85 full-text articles were deemed eligible for inclusion. Electroacupuncture and exercise were the most commonly assessed physiotherapy modalities.

In terms of quality, 80.8 percent of studies assessing exercise were deemed to be of good quality, while 33 percent of acupuncture and joint mobilization studies were low in quality. A quarter of electroacupuncture papers also had low methodological quality. Overall, only two papers had a low risk of bias

Despite large heterogeneities among studies, there was a broad consensus that physiotherapy could induce significant post-intervention changes in biomarkers associated with neuropathic pain. In particular, such interventions could downregulate pro-nociceptive markers while also boosting the activity of the opioid system or other pathways that help dampen neuropathy pain.

The present findings could be used to inform the design of future human studies, the researchers said, adding that future efforts in this field need to be more mindful of methodological and reporting standards.