Spiritual well-being in individuals with fibromyalgia syndrome: relationships with symptom pattern variability, uncertainty, and psychosocial adaptation

Tags:

• Adaptation, Psychological
• Adult
• Attitude to Health
• Female
• Fibromyalgia
• Humans
• Internet
• Male
• mental health
• Models, Psychological
• Nursing Methodology Research
• Quality of Life
• Questionnaires
• Regression Analysis
• Religion and Psychology
• Self Care
• Severity of Illness Index
• spirituality
• Stress, Psychological
• Uncertainty

Notes:

• This study examined relationships among symptom pattern variability, uncertainty, spiritual well-being, and psychosocial adaptation in individuals with fibromyalgia syndrome (FMS). A survey design was used with 58 individuals with FMS. The Fibromyalgia Symptom Pattern Questionnaire, Mishel Uncertainty in Illness Scale--Community Form, Spiritual Well-Being Scale, and Psychosocial Adjustment to Illness Scale-Self Report were used to collect data. Positive relationships were found between symptom pattern variability and uncertainty and between uncertainty and poor psychosocial adaptation; spiritual well-being moderated the relationship between uncertainty and psychosocial adaptation. A positive sense of well-being aided adaptation to symptoms and uncertainties of FMS. Spiritual well-being had a greater effect on the relationship between symptom pattern variability and uncertainty than expected.

Multimodal analgesia for chronic pain: rationale and future directions

Notes:

• Chronic pain is a multifaceted disease requiring multimodal treatment. Clinicians routinely employ various combinations of pharmacologic, interventional, cognitive-behavioral, rehabilitative, and other nonmedical therapies despite the paucity of robust evidence in support of such an approach. Therapies are selected consistent with the biopsychosocial model of chronic pain, reflecting the subjective nature of the pain complaint, and the myriad stressors that shape it. Elucidating mechanisms that govern normal sensation in the periphery has provided insights into the biochemical, molecular, and neuroanatomic correlates of chronic pain, an understanding of which is leading increasingly to mechanism-specific multidrug therapies. Peripheral and central neuroplastic reorganization underlying the disease of chronic pain is influenced by patient-specific emotions, cognition, and memories, further impairing function and idiosyncratically defining the illness of chronic pain. Clinical perceptions of these and related subjective elements associated with the suffering of chronic pain drive psychosocial treatments, including, among other options, relaxation therapies, coping skills development, and cognitive-behavioral therapy. Treatment selection is thus guided by comprehensive assessment of the phenomenology and inferred pathophysiology of the pain syndrome; patient goals, preferences, and expectations; behavioral, cognitive, and physical function; and level of risk. Experiential, practice-based evidence may be necessary for improving patient care, but it is insufficient; certainly, well-designed studies are needed to support therapeutic decision making. This review will discuss the biochemical basis of pain, factors that govern its severity and chronicity, and foundational elements for current and emerging multimodal treatment strategies.

Chronic pain and fatigue: Associations with religion and spirituality

Tags:

• Adaptation, Psychological
• Adolescent
• Adult
• Aged
• Canada
• Chronic Disease
• Cross-Sectional Studies
• Fatigue Syndrome, Chronic
• Female
• Health Surveys
• Humans
• Linear Models
• Male
• Middle Aged
• Pain
• religion
• Young Adult

Notes:

• The Canadian Community Health Survey (2002) obtained data from 37,000 individuals 15 years of age or older. From these data, four conditions with chronic pain and fatigue were analyzed together -- fibromyalgia, back pain, migraine headaches and chronic fatigue syndrome. Additional data from the survey were used to determine how religion and spirituality affect psychological well-being, as well as the use of various coping methods.

Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia

Tags:

• prepub

Notes:

• This study investigates the effects of alternative therapies on fibromyalgia. Mindfulness meditation was found to have generally beneficial results, while acupuncture had mixed results that tended positive. No effects were found for Qi Gong, biofeedback, or body awareness therapy.

Are spirituality and religiosity resources for patients with chronic pain conditions?

Tags:

• Adaptation, Psychological
• Attitude to Health
• Chronic Disease
• Cross-Sectional Studies
• Female
• Humans
• Male
• Middle Aged
• Pain
• Questionnaires
• Spiritualism
• spirituality

Notes:

• A study about whether or not spirituality/religiosity is a relevant resource for patients with chronic pain conditions, and to analyze interrelations between spirituality/religiosity (SpREUK Questionnaire; SpREUK is an acronym of the German translation of “Spiritual and Religious Attitudes in Dealing with Illness”), adaptive coping styles that refer to the concept of locus of disease control (AKU Questionnaire; AKU is an acronym of the German translation of “Adaptive Coping with Disease”), life satisfaction, and appraisal dimensions.

A Randomized Trial Comparing Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back Pain

Notes:

• This trial addresses the importance of needle placement and skin penetration in eliciting acupuncture effects for patients with chronic low back pain. Participants in the treatment groups were more likely than those receiving usual care to experience clinically meaningful improvements in dysfunction (59% to 65% vs 50%, respectively; P = .02) but not in symptoms (P > .05). Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits.

Mindfulness-based interventions for chronic pain: a systematic review of the evidence

Tags:

• Chronic Disease
• depression
• Humans
• Meditation
• Mind-Body Relations, Metaphysical
• Outcome Assessment (Health Care)
• Pain, Intractable

Notes:

• Chronic pain is a common disabling illness that does not completely respond to current medical treatments. As a consequence, in recent years many alternative interventions have been suggested. Among them, mindfulness-based interventions (MBIs) are receiving growing attention. The aim of the present article is to review controlled studies investigating the efficacy of MBIs for the reduction of pain and the improvement of depressive symptoms in patients suffering from chronic pain.A literature search was undertaken using MEDLINE,(®) ISI web of knowledge, the Cochrane database, and references of retrieved articles. The search included articles written in English published up to July 2009. The data were independently extracted by two reviewers from the original reports. Quality of included trials was also assessed.Ten (10) studies were considered eligible for the present review. Current studies showed that MBIs could have nonspecific effects for the reduction of pain symptoms and the improvement of depressive symptoms in patients with chronic pain, while there is only limited evidence suggesting specific effects of such interventions. Further findings evidenced some improvements in psychologic measures related to chronic pain such as copying with pain following MBIs as well.There is not yet sufficient evidence to determine the magnitude of the effects of MBIs for patients with chronic pain. Main limitations of reviewed studies include small sample size, absence of randomization, the use of a waiting list control group that does not allow distinguishing of specific from nonspecific effects of MBI as well as differences among interventions.However, because of these preliminary results, further research in larger properly powered and better designed studies is warranted.

A randomised controlled trial of yoga for the treatment of chronic low back pain: Results of a pilot study

Tags:

• Feasibility
• Low Back Pain
• Pilot study
• Primary care
• RCT
• yoga

Notes:

• This book is about a a pilot trial of yoga for the treatment of chronic low back pain (LBP) to inform the feasibility and practicality of conducting a full-scale trial in the UK; and to assess the efficacy of yoga for the treatment of chronic low back pain. This pilot study provided useful data and information to inform the design and development of a full-scale trial of yoga for CLBP in the UK. A key finding is the calculation of GP practice total list size required for patient recruitment in a full-scale trial, and the need to implement methods to increase class attendance.

A pragmatic multi-centred randomised controlled trial of yoga for chronic low back pain: trial protocol

Notes:

• A systematic review revealed three small randomised controlled trials of yoga for low back pain, all of which showed effects on back pain that favoured the yoga group. To build on these studies a larger trial, with longer term follow-up, and a number of different yoga teachers delivering the intervention is required. This study protocol describes the details of a randomised controlled trial (RCT) to determine the effectiveness and cost-effectiveness of Yoga for chronic Low Back Pain, which is funded by Arthritis Research Campaign (arc) and is being conducted by the University of York. 262 patients will be recruited from GP practices in 5 centres in England. Patients will be randomised to receive usual care or 12 weekly classes of yoga. A yoga programme will be devised that can be delivered by yoga teachers of the two main national yoga organisations in the UK (British Wheel of Yoga and Iyengar Yoga Association (UK)).

Evaluation of the Breathworks Mindfulness-Based Pain Management Programme: Effects on Well-Being and Multiple Measures of Mindfulness

Notes:

• Two studies of a mindfulness training program are presented. Study 1 reports on a pilot investigation of the impact on well-being of the Breathworks mindfulness-based pain management program. Significant positive change was found on self-report measures of depression, outlook, catastrophizing and pain self-efficacy in the Intervention Group, but not the Comparison Group. Particularly large effects were found for pain acceptance. These results support the short-term efficacy of the Breathworks program and reinforce the importance of acceptance for positive outcome with chronic pain patients. Study 2 investigated alterations in mindfulness following participation in the Breathworks program. Subjective and non-subjective measures of mindfulness were used. Scores on the Mindful Attention Awareness Scale were significantly higher at Time 2 in the Intervention Group, but not in the Comparison Group. There was no change on a measure of sustained attention. Results from an Implicit Association Test provided some support for an increased awareness of positive stimuli, following the intervention. These results are discussed with reference to the mechanisms of mindfulness.

Interactions Among Sex, Ethnicity, Religion, and Gender Role Expectations of Pain

Tags:

• ETHNICITY
• gender role expectations
• pain perception
• religion
• sex

Notes:

• This study examined the interaction among gender role expectations of pain, sex, and ethno-religious belonging. The study surveyed 548 healthy men and women of three different religious groups, 341 Jews, 105, Muslim-Arabs and 102 Christian-Arabs. The study concluded that individual's perception of pain regarding one's self compared with the same opposite sex were similar regardless of ethno-linguistic belonging and were related to sex.  

The effects of deep breathing training on pain management in the emergency department

Tags:

• Adolescent
• Adult
• Aged
• Breathing Exercises
• Emergency Service, Hospital
• Female
• Humans
• Male
• Middle Aged
• Pain
• Pain Measurement
• Patient Satisfaction
• Physician-Patient Relations
• Young Adult

Notes:

• Purpose: The purpose of this study was to measure the impact of deep breathing exercises on the pain levels in patients who presented to the emergency department (ED) with pain as their chief complaint. A secondary purpose was to measure the impact of deep breathing teaching on indicators of patient satisfaction. Results: There was no significant difference between those who received the deep breathing education and those that did not with regards to postmedication pain levels.

Attention management as a treatment for chronic pain

Tags:

• Attention management
• Chronic pain
• Cognitive-behavioural therapy
• Pain-related anxiety

Notes:

• Attention management is often included in cognitive-behavioural treatments (CBT). The aim of this study was to evaluate the effects of attention management strategies in the treatment for chronic pain. The present pilot study consisted of six weekly 90-min treatment sessions and was based on a CBT attention management manual describing techniques such as attention diversion, imagery and mindfulness exercises. The intended outcomes were reduction in pain-related anxiety and hypervigilance to pain and decrease in pain impact of everyday life, measured by self-report. Information was collected at baseline, pre-treatment, post-treatment, and at 3 and 6 months follow-up. The results at the end of treatment, and at 3-month follow-up, show significant reductions in pain-related anxiety, hypervigilance and interference of pain (effect sizes 0.40–0.90). Reduction in pain-related interference and anxiety remained at the 6-month follow-up. The results indicate that attention control skills can be a useful method to reduce anxiety in the short term. Clinical implications of the results are discussed.

Characteristics and Predictors of Short-Term Outcomes in Individuals Self-selecting Yoga or Physical Therapy for Treatment of Chronic Low Back Pain

Notes:

• To compare clinical and demographic characteristics of individuals self-selecting yoga or physical therapy (PT) for treatment of chronic low back pain (cLBP) and to examine predictors of short-term pain and functional outcomes. Descriptive, longitudinal study.A hospital-based clinic that offers modified integral yoga classes for cLBP and 2 outpatient PT clinics that offer exercise-based PT.Adults (n = 53) with cLBP ≥12 weeks: yoga (n = 27), PT (n = 26).Yoga participants attended a 6-week, once weekly, 2-hour yoga class. PT participants underwent twice weekly, 1-hour individualized PT. Data were collected at baseline and at 6 weeks. Groups were compared by using χ² and independent samples t-tests. Hierarchical linear regression was used to predict treatment outcomes.Disability (Roland Morris Disability Questionnaire), health status (Rand Short Form 36 Health Survey 1.0), pain bothersomeness (numerical rating scale), back pain self-efficacy (Back Pain Self-Efficacy Scale), and treatment satisfaction. At baseline, yoga participants were significantly less disabled (P = .013), had higher health status (P = .023), greater pain self-efficacy (P = .012), and less average pain bothersomeness (P = .001) compared with PT participants. At 6 weeks, when controlling for baseline group differences, greater pain self-efficacy was the strongest predictor for reduced pain and higher function for the entire sample. A significant group interaction by baseline pain self-efficacy predicted disability at 6 weeks. PT participants with low pain self-efficacy reported significantly greater disability than those with high pain self-efficacy. Yoga participants with low and high pain self-efficacy had similar disability outcomes.These findings strengthen evidence that self-efficacy is associated with cLBP outcomes, especially in individuals self-selecting PT. Further research to evaluate outcomes after yoga and PT in participants with low pain self-efficacy is needed.

Mindfulness meditation for women with chronic pelvic pain: a pilot study

Tags:

• Adult
• Chronic Disease
• Female
• Humans
• Meditation
• Middle Aged
• Pain Measurement
• Pelvic Pain
• Pilot Projects
• Quality of Life
• Questionnaires
• Treatment Outcome

Notes:

• Chronic pelvic pain (CPP) is a common condition that can be difficult to treat. Mindfulness meditation improves outcomes in patients with cancer pain, low back pain and migraine headaches. This study evaluates feasibility and efficacy of mindfulness for patients with CPP. Women with CPP were enrolled in an 8-week mindfulness program. Pre-assessments and post-assessments included daily pain scores, the Short Form-36 Health Status Inventory, Kentucky Inventory of Mindfulness Score and the Inventory of Depressive Symptomatology. Twelve out of 22 enrolled subjects completed the program and had significant improvement in daily maximum pain scores (p = 0.02), physical function (p = 0.01), mental health (p = 0.01) and social function (p = 0.02). The mindfulness scores improved significantly in all measures (p < 0.01).Data from this pilot study show the feasibility of mindfulness meditation in women with CPP. Initial pilot data suggest that quality of life and mindfulness outcomes may improve with mindfulness meditation and justify further investigation with a randomized, controlled trial.

Use of complementary and alternative medicine in patients suffering from primary headache disorders

Notes:

• A systematic questionnaire-based survey of CAM therapy was conducted in 432 patients who attended seven tertiary headache out-patient clinics in Germany and Austria. Use of CAM was reported by the majority (81.7%) of patients. This study confirms that CAM is widely used among primary headache patients, mostly in combination with standard care.

Intensive meditation for refractory pain and symptoms

Notes:

• The object of this study was to assess patient interest in intensive meditation training for chronic symptoms. The study concluded that over 50% of patients followed in chronic disease clinics complain of moderate to severe pain. Patients with persistent pain or stress are more likely to be interested in intensive meditation.

The effect of Qigong on fibromyalgia (FMS): a controlled randomized study

Tags:

• Adult
• Breathing Exercises
• Female
• Fibromyalgia
• Humans
• Middle Aged
• Pain
• Quality of Life
• Treatment Outcome

Notes:

• Purpose: To evaluate the effect of a 7-week Qigong intervention on subjects with Fibromyalgia Syndrome (FMS). Results: During the experimental part of the study, significant improvements were found for the intervention group, at posttreatment, regarding different aspects of pain and psychological health and distress. Almost identical results were found for the combined group. At 4-month follow-up, the majority of these results were either maintained or improved. Conclusion: The overall results show that Qigong has positive and reliable effects regarding FMS.

Religiosity/spirituality and pain in patients with sickle cell disease

Tags:

• Adaptation, Psychological
• Adolescent
• Adult
• African Americans
• Aged
• Ambulatory Care
• Anemia, Sickle Cell
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Pain
• Pain Measurement
• Psychiatric Status Rating Scales
• Quality of Life
• religion
• Religion and Psychology
• Severity of Illness Index
• spirituality
• Stress, Psychological

Notes:

Hypnosis for chronic pain management: A new hope

Notes:

• The aim of this study was to demonstrate that hypnosis has direct effects on many supraspinal sites involved in the experience of pain.

Perceptions of death, belief systems and the process of coping with chronic pain

Tags:

• Adaptation, Psychological
• Attitude to Death
• Chronic Disease
• Humans
• Pain
• Suicide

Notes:

• The process of coping with chronic pain most commonly involves both the search for medical or non-medical cure, and the search for meaning for intractable suffering. In this paper, I survey various religious, philosophical and mystical belief systems and their empirical use as resources for meaning.

Internal Qigong for Pain Conditions: A Systematic Review

Notes:

• The objective of this systematic review was to assess the evidence for the effectiveness of internal qigong as a treatment option for pain conditions. Collectively, the existing trial evidence is not convincing enough to suggest that internal qigong is an effective modality for pain management.

External qigong for pain conditions: a systematic review of randomized clinical trials

Tags:

• Breathing Exercises
• Humans
• Pain
• Pain Measurement
• Randomized Controlled Trials as Topic

Notes:

• The aim of this systematic review was to assess the clinical evidence of external qigong as a treatment option for pain conditions. A meta-analysis shows that evidence for the effectiveness of external qigong is encouraging, though further studies are warranted.

Internal qigong for pain conditions: a systematic review

Notes:

• The objective of this systematic review was to assess the evidence for the effectiveness of internal qigong as a treatment option for pain conditions. Nineteen databases were searched through to February 2009. Controlled clinical trials testing internal qigong in patients with pain of any origin assessing clinical outcome measures were considered. Trials using any type of internal qigong and control intervention were included. The selection of studies, data extraction, and validation were performed independently by 2 reviewers. Four randomized clinical trials (RCTs) and 3 controlled clinical trials met all inclusion criteria. One RCT suggested no significant difference for low back pain compared with electromyographic biofeedback. Two RCTs failed to show effects of internal qigong in neck pain compared with exercise therapy and waiting list control. One RCT suggested that qigong is inferior to aerobic exercise in patients with fibromyalgia. There are few RCTs testing the effectiveness of internal qigong in the management of pain conditions. Collectively, the existing trial evidence is not convincing enough to suggest that internal qigong is an effective modality for pain management. PERSPECTIVE: This review of controlled clinical trials focused on the effects of internal qigong, a self-directed energy healing intervention involving movement and meditation. Collectively, the existing trial evidence is not convincing enough to suggest that internal qigong is an effective modality for pain management. Future studies should be of high quality with particular emphasis on designing an adequate control intervention.

The Effectiveness of Cognitive and Behavioural Treatment of Chronic Pain in the Elderly: A Quantitative Review

Mindfulness meditation for symptom reduction in fibromyalgia: psychophysiological correlates

Tags:

• Adult
• Aged
• Anxiety
• Arousal
• depression
• Female
• Fibromyalgia
• Galvanic Skin Response
• Heart Rate
• Humans
• Male
• Meditation
• Middle Aged
• Personality Inventory
• Psychometrics
• Psychophysiologic Disorders
• Skin Temperature
• Sympathetic Nervous System
• Young Adult

Notes:

• This second study explores the effects of MBSR on basal sympathetic (SNS) activation among women with fibromyalgia. Results: The MBSR treatment significantly reduced basal electrodermal (skin conductance level; SCL) activity (t = 3.298, p = .005) and SCL activity during meditation (t = 4.389, p = .001), consistent with reduced SNS activation.

Psychological flexibility in adults with chronic pain: A study of acceptance, mindfulness, and values-based action in primary care

Tags:

• Acceptance
• Chronic pain
• Cognitive behavioral therapy
• Disability
• Mindfulness
• Psychological flexibility

Notes:

• There is an increasing number of studies of acceptance, mindfulness, and values-based action in relation to chronic pain. Evidence from these studies suggests that these processes may be important for reducing the suffering and disability arising in these conditions. Taken together these processes entail an overarching process referred to as “psychological flexibility.” While these processes have been studied in people with chronic pain contacted in specialty treatment centers, they have not yet been investigated in primary care. Thus, participants in this study were 239 adults with chronic pain surveyed in primary care, through contact with their General Practitioners (GPs), in the UK. They completed measures of acceptance of chronic pain, mindfulness, psychological acceptance, values-based action, health status, and GP visits related to pain. Correlation coefficients demonstrated significant relations between the components of psychological flexibility and the measures of health and GP visits. In regression analyses, including both pain intensity and psychological flexibility as potential predictors, psychological flexibility accounted for significant variance, ΔR²=.039–.40 (3.9–40.0%). In these regression equations pain intensity accounted for an average of 9.2% of variance while psychological flexibility accounted for 24.1%. These data suggest that psychological flexibility may reduce the impact of chronic pain in patients with low to moderately complex problems outside of specialty care. Due to a particularly conservative recruitment strategy the overall response rate in this study was low and the generality of these results remains to be established.

Religiosity may alter the cold pressor stress response

The paradox of healing pain

Notes:

• Pain may be seen as a problem to be healed or as a means for healing. The secular biomedical view of pain is that it is to be avoided and alleviated; its only meaning is as a symptom of underlying disease. In contrast, there have been throughout history other views of suffering—as redemptive or as transformative, for example. This paper considers the disparity between these perspectives, examining the role of the emotions and the underlying neurobiological processes though which pain and suffering come to be experienced as meaningful, then analyzes interview material exploring how religion and religious beliefs help people cope with suffering or with pain. The experience of pain is subjective, enculturated experience; the meaning that pain or suffering holds within a given cultural context affects the experience of pain and suffering. In a context where pain and suffering are understood to be valuable, those experiences can be used for spiritual transformation and integrated within a meaningful identity. In contrast, in a context where pain and suffering are not understood to have value, that attitude can create more suffering, even in conditions meant to alleviate suffering, such as in biomedical situations.

Effectiveness of mindfulness meditation (Vipassana) in the management of chronic low back pain

The relationship between religion/spirituality and physical health, mental health, and pain in a chronic pain population

Tags:

• Activities of Daily Living
• Adolescent
• Adult
• Aged
• Attitude to Health
• Chronic Disease
• DEMOGRAPHY
• Disability Evaluation
• Female
• Humans
• Male
• mental health
• Middle Aged
• Pain
• Pain Measurement
• Quality of Life
• Questionnaires
• Regression Analysis
• Religion and Psychology
• social support

Notes:

• This study sought to better understand the relationship between religion/spirituality and physical health and mental health in 122 patients with chronic musculoskeletal pain.

Counseling clients with chronic pain: A religiously oriented cognitive behavior framework.

Tags:

• Chronic pain
• Cognitive Assessment
• cognitive behavior framework
• cognitive behavior strategies
• Cognitive Processes
• core schemas
• Counseling
• counseling clients
• religion
• Religious Practices
• Schema
• strategies

Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice

Tags:

• Chronic pain
• Compliance
• Effect size
• Health-related quality of life
• Meditation
• Mindfulness-Based Stress Reduction
• Psychological distress

Notes:

• This study compared changes in bodily pain, health-related quality of life (HRQoL), and psychological symptoms during an 8-week mindfulness-based stress reduction (MBSR) program among groups of participants with different chronic pain conditions.From 1997-2003, a longitudinal investigation of chronic pain patients (n=133) was nested within a larger prospective cohort study of heterogeneous patients participating in MBSR at a university-based Integrative Medicine center. Measures included the Short-Form 36 Health Survey and Symptom Checklist-90-Revised. Paired t tests were used to compare pre–post changes on outcome measures. Differences in treatment effect sizes were compared as a function of chronic pain condition. Correlations were examined between outcome parameters and home meditation practice.Outcomes differed in significance and magnitude across common chronic pain conditions. Diagnostic subgroups of patients with arthritis, back/neck pain, or two or more comorbid pain conditions demonstrated a significant change in pain intensity and functional limitations due to pain following MBSR. Participants with arthritis showed the largest treatment effects for HRQoL and psychological distress. Patients with chronic headache/migraine experienced the smallest improvement in pain and HRQoL. Patients with fibromyalgia had the smallest improvement in psychological distress. Greater home meditation practice was associated with improvement on several outcome measures, including overall psychological distress, somatization symptoms, and self-rated health, but not pain and other quality of life scales.MBSR treatment effects on pain, HRQoL and psychological well-being vary as a function of chronic pain condition and compliance with home meditation practice.

Yoga for chronic low back pain in a predominantly minority population: a pilot randomized controlled trial

Notes:

• Several studies suggest yoga may be effective for chronic low back pain; however, trials targeting minorities have not been conducted. PRIMARY STUDY OBJECTIVES: Assess the feasibility of studying yoga in a predominantly minority population with chronic low back pain. Collect preliminary data to plan a larger powered study. Pilot randomized controlled trial. Two community health centers in a racially diverse neighborhood of Boston, Massachusetts. Thirty English-speaking adults (mean age 44 years, 83% female, 83% racial/ethnic minorities; 48% with incomes < or = $30,000) with moderate-to-severe chronic low back pain. Standardized series of weekly hatha yoga classes for 12 weeks compared to a waitlist usual care control.Feasibility measured by time to complete enrollment, proportion of racial/ethnic minorities enrolled, retention rates, and adverse events. Primary efficacy outcomes were changes from baseline to 12 weeks in pain score (0=no pain to 10=worst possible pain) and back-related function using the modified Roland-Morris Disability Questionnaire (0-23 point scale, higher scores reflect poorer function). Secondary efficacy outcomes were analgesic use, global improvement, and quality of life (SF-36).Recruitment took 2 months. Retention rates were 97% at 12 weeks and 77% at 26 weeks. Mean pain scores for yoga decreased from baseline to 12 weeks (6.7 to 4.4) compared to usual care, which decreased from 7.5 to 7.1 (P=.02). Mean Roland scores for yoga decreased from 14.5 to 8.2 compared to usual care, which decreased from 16.1 to 12.5 (P=.28). At 12 weeks, yoga compared to usual care participants reported less analgesic use (13% vs 73%, P=.003), less opiate use (0% vs 33%, P=.04), and greater overall improvement (73% vs 27%, P=.03). There were no differences in SF-36 scores and no serious adverse events. A yoga study intervention in a predominantly minority population with chronic low back pain was moderately feasible and may be more effective than usual care for reducing pain and pain medication use. 

Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain

Tags:

• Acceptance
• Attention
• Catastrophizing
• Chronic pain
• Cognition
• Fear-avoidance
• Mindfulness

Notes:

• The relationship between persistent pain and self-directed, non-reactive awareness of present-moment experience (i.e., mindfulness) was explored in one of the dominant psychological theories of chronic pain – the fear-avoidance model [53]. A heterogeneous sample of 104 chronic pain outpatients at a multidisciplinary pain clinic in Australia completed psychometrically sound self-report measures of major variables in this model: Pain intensity, negative affect, pain catastrophizing, pain-related fear, pain hypervigilance, and functional disability. Two measures of mindfulness were also used, the Mindful Attention Awareness Scale [4] and the Five-Factor Mindfulness Questionnaire [1]. Results showed that mindfulness significantly negatively predicts each of these variables, accounting for 17–41% of their variance. Hierarchical multiple regression analysis showed that mindfulness uniquely predicts pain catastrophizing when other variables are controlled, and moderates the relationship between pain intensity and pain catastrophizing. This is the first clear evidence substantiating the strong link between mindfulness and pain catastrophizing, and suggests mindfulness might be added to the fear-avoidance model. Implications for the clinical use of mindfulness in screening and intervention are discussed.

Effectiveness of integrated yoga therapy in treatment of chronic migraine: randomized controlled trial

Notes:

• To test the effectiveness of a integrated yoga therapy program for chronic migraine treatment in a low cost, nonclinical setting, a prospective, randomized, controlled trial was conducted in Jaipur, India. Subjects aged 18–65 years with 15 or more headache days per month, at least half of which were migraine/migrainous headaches, were randomized 1:1 to either yoga therapy or standard management. Seventy men and women were randomly assigned. The intervention group went through individualized yoga treatment for 12-weeks with four consecutive therapeutic sessions a week. Each therapy session lasting for about 60 min focusing on strengthening, relaxation, releasing muscular tension and increasing self efficacy. The control group consisted of standard care with the patient's physician. Outcome measures included self-perceived pain intensity, frequency, and duration; functional status; depression; prescription and nonprescription medication use. Outcomes were measured at the end of the 12-week intervention and at a 6-month follow-up.

  Positive health related outcomes in chronic migraine can be obtained with a low cost, group, integrated yoga in a community based nonclinical setting.

  Results: Thirty-one of 35 patients from the intervention group and all 35 patients from the control group completed the study. There were no statistically significant differences between the two groups before intervention. Intention to treat analysis revealed that the intervention group experienced statistically significant changes in self-perceived pain frequency (P = .000), pain intensity (P = .001), pain duration (P = .000), functional status (P = .000), medication used (P < 0.01) and depression (P = .000); these differences retained their significance at the 6-month follow-up.

   

Effectiveness of CAM therapy: understanding the evidence

Hypnosis Treatment for Chronic Low Back Pain

Notes:

Effect of yoga on musculoskeletal discomfort and motor functions in professional computer users

Tags:

• Adult
• Computers
• Female
• Hand Strength
• Humans
• Male
• Motor Activity
• Muscle Fatigue
• Occupational Diseases
• Pain
• Pain Measurement
• Range of Motion, Articular
• Treatment Outcome
• yoga

Notes:

• The self-rated musculoskeletal discomfort, hand grip strength, tapping speed, and low back and hamstring flexibility (based on a sit and reach task) were assessed in 291 professional computer users. They were then randomized as Yoga (YG; n=146) and Wait-list control (WL; n=145) groups. Follow-up assessments for both groups were after 60 days during which the YG group practiced yoga for 60 minutes daily, for 5 days in a week. The WL group spent the same time in their usual recreational activities. At the end of 60 days, the YG group (n=62) showed a significant decrease in the frequency, intensity and degree of interference due to musculoskeletal discomfort, an increase in bilateral hand grip strength, the right hand tapping speed, and low back and hamstring flexibility (repeated measures ANOVA and post hoc analysis with Bonferroni adjustment). In contrast, the WL group (n=56) showed an increase in musculoskeletal discomfort and a decrease in left hand tapping speed. The results suggest that yoga practice is a useful addition to the routine of professional computer users.

The effects of distant healing performed by a spiritual healer on chronic pain: a randomized controlled trial

Tags:

• Adult
• Aged
• Aged, 80 and over
• Chronic Disease
• Double-Blind Method
• Female
• Humans
• Male
• Meditation
• Middle Aged
• Pain
• Pain Measurement
• Spiritual Therapies

Qigong and exercise therapy for elderly patients with chronic neck pain (QIBANE): a randomized controlled study

Tags:

• Aged
• Breathing Exercises
• Chronic Disease
• Data Interpretation, Statistical
• Exercise Therapy
• Female
• Humans
• Middle Aged
• Neck Pain
• Pain Measurement
• Quality of Life
• Treatment Outcome

Notes:

• The aim of this study was to evaluate the effectiveness of qigong compared with exercise therapy and no treatment. We found no significant effect after 3 months of qigong or exercise therapy compared with no treatment.

Targeting Acceptance, Mindfulness, and Values-Based Action in Chronic Pain: Findings of Two Preliminary Trials of an Outpatient Group-Based Intervention

Notes:

• Cognitive behavior therapy (CBT) for chronic pain is effective, although a number of issues in need of clarification remain, including the processes by which CBT works, the role of cognitive changes in the achievement of outcomes, and the formulation of a coherent theoretical model. Recent developments in psychology have attempted to address these issues by focusing specifically on processes of acceptance, present-focused awareness (e.g., mindfulness), and values-based action. The present study evaluated the effectiveness of Acceptance and Commitment Therapy (ACT), perhaps the most widely researched of these developing approaches. Initial evidence suggests that ACT-consistent treatments for chronic pain are effective, although there is a need to study treatment in more traditional pain-management settings, where treatment is generally time-limited, unidisciplinary, and outpatient. Data from two pilot studies are presented. Results support the feasibility of treatment and suggest that effectiveness rates compare favorably with more established forms of treatment, in this case, CBT. Although these data are preliminary, they set a foundation upon which more intensive evaluations can take place.

Feasibility and short-term outcomes of a shamanic treatment for temporomandibular joint disorders

Tags:

• Adult
• Facial Pain
• Feasibility Studies
• Female
• Humans
• Male
• Oregon
• Pain Measurement
• Patient Satisfaction
• Shamanism
• spirituality
• Temporomandibular Joint Disorders
• Treatment Outcome

Notes:

• Context: Temporomandibular joint disorders (TMDs) are chronic, recurrent, non-progressive pain conditions affecting the jaw and face. Objective: This phase 1 study tested feasibility and safety of shamanic healing for TMDs. Results: This study demonstrated the feasibility and acceptability of clinical trials of shamanic healing.

What physicians should know about spirituality and chronic pain

Migraines and meditation: does spirituality matter?

Notes:

• This study examined two primary questions: (1) Is spiritual meditation more effective in enhancing pain tolerance and reducing migraine headache related symptoms than secular meditation and relaxation? and, (2) Does spiritual meditation create better mental, physical, and spiritual health outcomes than secular meditation and relaxation techniques?

Does spirituality as a coping mechanism help or hinder coping with chronic pain?

Notes:

• Many chronic pain patients use religious/spiritual forms of coping, such as prayer and spiritual support, to cope with their pain. This article explores empirical research that illustrates how religion/spirituality may impact the experience of pain and may help or hinder the coping process.

Does spirituality as a coping mechanism help or hinder coping with chronic pain?

Tags:

• Adaptation, Psychological
• Chronic Disease
• Health Personnel
• Humans
• Pain
• Religion and Medicine
• spirituality
• Treatment Outcome

Exploring the relationship between spirituality, coping, and pain

Notes:

• This article explores the relationship between the experience of pain and religion/spirituality with the aim of understanding not only why some people rely on their faith to cope with pain, but also how religion/spirituality may impact the experience of pain and help or hinder the coping process.

Effects of qigong on late-stage complex regional pain syndrome

Tags:

• Adolescent
• Adult
• Aged
• Breathing Exercises
• Middle Aged
• Reflex Sympathetic Dystrophy
• Time Factors
• Treatment Outcome

Notes:

• Objective: To study the effect of qigong on treatment-resistant patients with late-stage complex regional pain syndrome type I. INTERVENTIONS: The experimental group received qi emission and qigong instruction (including home exercise) by a qigong master. Results: 82% reported less pain by the end of the first training session compared to 45% of control patients. Anxiety was reduced in both groups over time, but the reduction was significantly greater in the experimental group than in the control group.

The effects of slow breathing on affective responses to pain stimuli: An experimental study

Tags:

• Affect
• Fibromyalgia
• Pain
• Slow breathing

Notes:

• This study examined whether breathing rate affected self-reported pain and emotion following thermal pain stimuli in women with fibromyalgia syndrome (FM: n=27) or age-matched healthy control women (HC: n=25). FM and HC were exposed to low and moderate thermal pain pulses during paced breathing at their normal rate and one-half their normal rate. Thermal pain pulses were presented in four blocks of four trials. Each block included exposure to both mild and moderate pain trials, and periods of both normal and slow paced breathing. Pain intensity and unpleasantness were recorded immediately following each pain trial, and positive and negative affect were assessed at the end of each block of trials. Compared to normal breathing, slow breathing reduced ratings of pain intensity and unpleasantness, particularly for moderately versus mildly painful thermal stimuli. The effects of slow breathing on pain ratings were less reliable for FM patients than for HCs. Slow versus normal breathing decreased negative affect ratings following thermal pain pulses for both groups, and increased positive affect reports, but only for healthy controls with high trait negative affect. Participants who reported higher levels of trait positive affect prior to the experiment showed greater decreases in negative affect as a result of slow versus normal breathing. These experimental findings provide support for prior reports on the benefits of yogic breathing and mindful Zen meditation for pain and depressed affect. However, chronic pain patients may require more guidance to obtain therapeutic benefit from reduced breathing rates.

The effects of brief mindfulness meditation training on experimentally induced pain

Notes:

• This study investigated the effects of brief mindfulness meditation training on ratings of painful electrical stimulation. In Experiment 1, we used a 3-day (20 min/d) mindfulness meditation intervention and measured pain ratings before and after the intervention. Participants' numerical ratings of pain to “low” and “high” electrical stimulation significantly decreased after meditation training. Pain sensitivity, measured by change in stimulus intensity thresholds, also decreased after training. We investigated, in Experiment 2, how well relaxation and a math distraction task attenuated experimental pain. Math distraction but not relaxation reduced high pain ratings. There was no reduction in pain sensitivity in these participants. In Experiment 3, we directly compared the effects of meditation with math distraction and relaxation conditions. Our findings indicated significant effects of both meditation and math distraction. Consistent with what was observed in Experiment 1, these participants also demonstrated a decrease in pain sensitivity after meditation training. Changes in the mindfulness and anxiety assessments suggest that meditation's analgesic effects are related to reduced anxiety and the enhanced ability to focus on the present moment.