systematic review of the effectiveness of self-initiated interventions to decrease pain and sensory disturbances associated with peripheral neuropathy

A small number of studies report that patients with peripheral neuropathy (pn) who engage in activities that promote a sense of personal well-being and provide physical, emotional, or spiritual comfort have a better quality of life and higher levels of adjustment to the changes generated by their illness and accompanying symptoms. this systematic review sought to evaluate the effectiveness of self-management activities that patients with pn initiate themselves to relieve pn symptoms and improve quality of life. search terms were limited to include self-management activities initiated by patients (i.e., activities with no or minimal involvement from clinicians) that aim to provide relief of pn symptoms. outcomes included in searches were pain, numbness, and tingling, associated with pn and quality of life. the database searches identified 2979 records, of which 1620 were duplicates. a total of 1322 papers were excluded on the basis of screening the abstract. an additional 21 full text articles were excluded because they did not meet the eligibility criteria. a total of 16 papers were included in the review. this review identified that a number of self-management strategies that were initiated by patients, including heat, exercise, meditation, and transcutaneous electrical nerve stimulation (tens) therapy, reduce self-reported pn symptoms. as the available studies were of low quality, these strategies warrant further investigation with more homogeneous samples, using more rigorously designed trials and larger samples. patients experiencing pn find a range of self-initiated strategies beneficial in reducing pn symptoms and improving quality of life. however, because of the low quality of the available studies, clinicians need to monitor patients’ responses to determine the effectiveness of these interventions as adjuncts to clinician-initiated interventions.