A Complementary Approach to Pain Management

Meenakshi Khatta, MS, CRNP

Disclosures

Topics in Advanced Practice Nursing eJournal. 2007;7(1) 

In This Article

Mind-Body Therapy (MBT)

The National Institutes of Health's (NIH) National Center for Complementary and Alternative Medicine defines mind-body medicine as "behavioral, psychologic, social, and spiritual approaches to medicine not commonly used." MBTs include:

  • Meditation;

  • Imagery;

  • Biofeedback;

  • Relaxation; and

  • Hypnosis.

A meta-analysis of 25 randomized trials looking at a variety of mind-body interventions as adjunctive therapy in the management of rheumatoid arthritis (RA) suggested that mind-body interventions may be effective in patients who have had RA for a short time.[31]

The most researched MBT for arthritis has been the Arthritis Self-Management Program (ASMP).[32] This community-based intervention consists of:

  • Education;

  • Cognitive restructuring;

  • Physical activity to reduce pain;

  • Problem solving;

  • Relaxation; and

  • Development of skills to communicate with healthcare professionals.

Participants in ASMP experienced reductions in pain lasting 4 years post-intervention and amounting to a savings of 4 to 5 times the cost of the program per individual.[33]

Jon Kabat-Zinn, PhD, and colleagues from the Stress Reduction Clinic, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, have published a series of studies suggesting that mindfulness meditation may be an effective strategy for helping chronic pain patients cope more effectively with their conditions.[34,35] Even though the studies lack adequate control groups, a 4-year follow-up showed that 60% to 72% of the 225 patients who had completed this 8-week mindfulness meditation program reported "moderate to great improvement" in pain status.[34]

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