Meta-analysis: Mind and body procedures relieve pain and avoid ... 2

Meta-analysis: Mind and body procedures relieve pain and avoid …


Salt Lake City – meditation / mindfulness, hypnosis, relaxation exercises, suggestion, imaginative psychotherapy and cognitive-behavioral therapy can help manage acute and chronic pain, and help prevent opioid prescriptions. This is the result of a meta-analysis JAMA Internal Medicine (2019; doi: 10.1001 / jamainternmed.2019.4917).

The opioid crisis has shown doctors and patients in the US that there is no easy solution to treat severe pain. According to unlimited estimates of opiates, according to current estimates in JAMA Network Open (2019; 2: e187621) in the United States, probably by 2025, lead to 700,000 deaths.

Given these figures, the willingness of conventional medicine physicians to provide complementary mind-body procedures has increased. The offer is wide and its effectiveness has been extremely well studied by randomized trials.

Eric Garland, director of the Center for the Care and Development of Integrative Health Interventions at the University of Utah in Salt Lake City, used 60 publications with 6,404 participants for his systematic review and meta-analysis.

Among them were five studies of meditation and wakefulness exercises, 25 studies of hypnosis, and 14 studies of various relaxation exercises. 7 studies investigated the effectiveness of imaginative psychotherapy, 6 studies the effect of therapeutic suggestions and 7 the effect of cognitive behavioral therapy.

Garland calculated how well they support pain management and whether they can reduce opioid use for various mind and body procedures. For the treatment of pain, he determined a Cohen value of 0.51, which was significant with a 95% confidence interval of 0.26 to 0.76. Cohen d value is a measure of effect size. A value of 1.0 equals the difference of one standard deviation (which allows comparison of test results with different endpoints). The value of 0.51 corresponds to the magnitude of the mean effect.

The largest effect sizes were found for meditation (Cohen d 0.70), hypnosis (Cohen d 0.54), suggestion (Cohen d 0.68), and behavioral cognitive therapies (Cohen d 0.43).

To reduce the opioid dose, Garland determined a Cohen value of 0.26 (0.08 to 0.44). Here, too, the magnitude of the effect is significant, but rather weak on the scale. Different mind and body procedures are complementary therapies that can alleviate pain. However, the demand for opioids will only slightly decrease.

To combat the opioid crisis, mind and body procedures are unlikely to be capable, especially since patients take opioids after a short time, no longer to treat pain, but to avoid withdrawal symptoms (which is difficult to differentiate as withdrawal symptoms are often experienced as pain ).

However, mind and body procedures could help avoid further addictions. This indicates good efficacy in acute pain that occurs in the context of medical treatments. Mostly used are hypnosis studies, relaxation exercises, suggestions and imaginative techniques. Meditation and mindfulness, on the other hand, work more effectively with chronic pain. © Heat /