Venous leg ulcers (VLUs) are commonly associated with persistent chronic pain that adversely affects patient quality of life and wellbeing. Pain management in this population frequently relies on pharmacological agents, including opioids, which may produce undesirable effects and complications. There is growing interest in complementary and alternative approaches to reduce reliance on medications and improve holistic outcomes for people living with VLUs.
The purpose of the integrative literature review was to identify and synthesize evidence on non‑pharmacological interventions used to manage chronic pain in individuals affected by venous leg ulcers. The review sought to include diverse study methodologies to capture a broad view of available interventions and their reported effects on pain and related outcomes.
An integrative review design was used to enable inclusion of studies with different methodologies. Included studies were critically appraised for methodological quality. The PubMed abstract reports that 16 studies met the eligibility criteria. The appraisal classified study quality into three tiers: two studies were rated as strong, eight as methodologically moderate, and six as weak. The abstract does not provide further detail on search strategy, inclusion/exclusion criteria, individual study designs, outcome measures, or quantitative effect sizes.
Across the 16 eligible studies, methodological robustness varied. Two studies were judged strong, suggesting some higher‑quality evidence exists, but the preponderance of moderate and weak studies indicates limitations in study design, reporting, or sample size across the literature. Specific characteristics of individual studies (such as participant numbers, trial duration, control conditions, and statistical outcomes) are not reported in the source abstract and therefore cannot be summarized here.
The review identified several non‑pharmacological modalities that have been applied to pain management in people with VLUs. These included:
These interventions reflect a range of physical modalities, sensory and psychological approaches, and culturally based therapies reported in the literature.
The authors concluded that effective non‑pharmacological therapies for VLU‑related chronic pain do exist and that these approaches can improve quality of life and overall wellbeing. Within the body of evidence, compression bandaging, electrical stimulation, and virtual reality were singled out as the most effective and the most feasible for implementation in clinical practice according to the review’s synthesis. The abstract does not provide detailed comparative effect sizes or levels of certainty for each intervention.
The review supports consideration of non‑pharmacological options as part of a holistic pain management strategy in patients with VLUs. Clinicians may consider integrating feasible approaches such as appropriate compression therapy, where indicated, and exploring adjunctive modalities such as electrical stimulation or virtual reality interventions to complement pharmacological regimens. Implementation should be informed by local resources, patient preference, and clinical judgment, noting that the strength of evidence varies across interventions.
The authors recommend further research that adopts complex study methodologies appropriate to the multifaceted nature of VLU care. Such research would help evaluate interventions within the real‑world complexity of wound management and provide higher quality evidence to support a holistic approach to pain management in this population. Specific recommendations for study design elements, outcome measures, or standardized protocols are not detailed in the abstract.
The source article declared no conflicts of interest. The review was published in the British Journal of Nursing (Br J Nurs), with bibliographic details reported in the PubMed entry (PMID 42555598; DOI 10.12968/bjon.2025.0464). The abstract does not include detailed trial data or full methodological appendices; those details would require access to the full article.