Quality of life outcomes in neuropathic orofacial pain: an umbrella review of therapeutic interventions

Pain Manag. 2026 Jun 13:1-14. doi: 10.1080/17581869.2026.2688376. Online ahead of print.

ABSTRACT

BACKGROUND: Neuropathic orofacial pain comprises chronic conditions that severely affect daily function, psychological well-being, and quality of life, yet no umbrella review has synthesized how available treatments influence quality-of-life outcomes.

OBJECTIVE: To critically summarize evidence from systematic reviews and meta-analyses evaluating the impact of therapeutic interventions on quality-of-life-related outcomes in neuropathic orofacial pain.

METHODS: This umbrella review followed Joanna Briggs Institute methodology and PRISMA 2020. PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from inception to 2 January 2026. Eligible studies were systematic reviews/meta-analyses of therapeutic interventions for neuropathic orofacial pain reporting quality-of-life or patient-reported outcomes. Quality was assessed with AMSTAR 2 and ConQual.

RESULTS: Seven systematic reviews were included. Overlap was slight (CCA = 2.14%) and disappeared after adjustment (CCA = 0%). Repetitive transcranial magnetic stimulation improved selected patient-reported domains (MD -9.23; 95% CI-11.91 to -6.54). Microvascular decompression showed sustained pain relief, with benefits inferred from satisfaction and functional recovery. Pulsed radiofrequency improved short-term pain/sleep outcomes. Botulinum toxin type A reduced pain but not broader quality-of-life domains.

CONCLUSIONS: These interventions may improve quality-of-life-related outcomes when pain control is sustained, but evidence remains indirect and methodologically limited.

PROTOCOL REGISTRATION: PROSPERO, http://www.crd.york.ac.uk/prospero, identifier CRD420251276623.

PMID:42287136 | DOI:10.1080/17581869.2026.2688376