Research: CARROLL and SEERS,

Listed in Issue 34

Abstract

CARROLL and SEERS, Nuffield Department of Anaesthetics, University of Oxford, The Churchill, UK conducted a systematic review (54 references) of published randomised controlled trials regarding the effectiveness of relaxation techniques in the management of chronic pain.

Background

Methodology

The authors searched MEDLINE, psychLITT, CINAHL, EMBASE and the Oxford Pain Relief Database. Only randomised controlled trials of relaxation techniques in chronic pain were included in this review. Studies investigating the effects of relaxation in combination with other interventions were not considered. 9 studies involving 414 patients met the predefined inclusion criteria and are critically appraised. Lack of quantitative data in the primary studies precluded meta-analysis. The studies involved patients suffering from a range of chronic pain conditions; the most common pain outcome used was the McGill Pain Questionnaire.

Results

4 studies showed a significant difference in pain outcomes in favour of relaxation for the pre- and post-treatment assessments, but there were few statistically significant differences reported in favour of relaxation with between treatment comparisons. 3 studies reported statistically significant differences in favour of relaxation compared to the other treatment groups. For rheumatoid arthritis the McGill Pain Questionnaire scores were significantly lower for patients receiving relaxation compared to those in the control group. For ulcerative colitis there were significant differences reported in 6 out of 7 pain outcome measures in favour of progressive muscle relaxation compared to the waiting list control group. In one of the two cancer pain studies, relaxation produced significantly lower pain sensation scores compared to control patients. Two studies reported significant differences for the experimental control groups rather than for relaxation.

Conclusion

There is insufficient evidence to confirm that relaxation reduces chronic pain. Many studies with both positive and negative results have suffered from methodological inadequacies, and the authors make recommendations for future research regarding the effectiveness of relaxation techniques for chronic pain.

References

Carroll D and Seers K. Relaxation for the relief of chronic pain: a systematic review. J Adv Nurs 27(3): 476-87 Mar 1998.

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