Alternative therapies in chronic non-cancer pain management: A scoping review of randomized controlled trials

BACKGROUND: Chronic pain is one of the most challenging health problems in modern society, placing significant burdens on individuals and healthcare systems. While pharmacological treatments remain the primary approach to pain management, their limitations often restrict choices for both clinicians and patients. In contrast, complementary therapies are gaining recognition for their potential effectiveness and safety. However, the current literature lacks a comprehensive summary of the role of complementary therapies in chronic pain management. OBJECTIVE: This review aims to summarize the complementary therapies used in chronic non-cancer pain management, assess their practical applications, identify research gaps and limitations, and provide a comprehensive perspective for the development of chronic non-cancer pain management and personalized pain management strategies. METHODS: This scoping review followed the PRISMA-ScR guidelines. Randomized controlled trials (RCTs) published in the last decade were retrieved from PubMed and Web of Science using the keywords "chronic pain" and "complementary therapy." Non-English studies were excluded. RESULTS: A total of 848 RCTs were identified, of which 128 met the inclusion criteria. The included studies addressed chronic musculoskeletal pain (102 studies), chronic visceral pain (5 studies), chronic neuropathic pain (7 studies), and 13 studies that did not specify the pain type. The complementary therapies investigated included acupuncture, manual therapy, exercise therapy, psychological interventions, mind-body therapies, and physical modalities. CONCLUSION: This review provides preliminary evidence supporting the efficacy and safety of complementary therapies in the management of chronic non-cancer pain. However, methodological and quality-related limitations were identified in the included studies. Future high-quality RCTs are needed to validate the long-term efficacy of these therapies, explore their mechanisms of action, and provide stronger evidence for their clinical application. REGISTRATION: This scoping review is registered on the Open Science Framework (OSF) under the following DOI: https://doi.org/10.17605/OSF.IO/67K32.