Say Om: yoga and other therapies good for chronic pain

Ask devotees about the benefits conferred by alternative therapies such as yoga, tai chi and hypnosis, and they'll tell you the list is lengthy. After a recent review by researchers at the University of Pittsburgh, chronic pain management can be added to the list.

According to the study, chronic non-malignant pain occurs in up to 50 per cent of older adults.

Researchers reviewed 20 clinical trials involving eight mind-body therapies for adults who suffered from chronic, non-malignant pain, to assess their feasibility, effectiveness in pain management and safety.

The findings are published in Volume 8 of the journal Pain Medicine.

The therapies reviewed included biofeedback (learning to control body functions) , progressive muscle relaxation (tensing and releasing muscles), meditation, guided imagery (visualization techniques), hypnosis, tai chi chuan (a Chinese martial art consisting of sequences of very slow, controlled movements) qi gong (movements that include elements of meditation, relaxation and physical movement), and yoga.

All eight treatments were found to be feasible for older adults, and no adverse events or safety concerns were reported. Researchers found that progressive muscle relaxation may be particularly effective for older people with osteoarthritis pain, while meditation and tai chi appear to improve function and coping with low back pain and osteoarthritis.

The benefits of the various therapies were assessed individually:

• Biofeedback: seen as beneficial for chronic low-back pain, headache and rheumatologic pain.
• Progressive muscle relaxation: though some studies found that it improved headaches, little evidence exists about its effect on other types of chronic pain.
• Mindfulness meditation and hypnosis meditation: seen as helpful in reducing low back pain.
• Guided imagery: found to help improve mobility and reduce osteoarthritis pain
• Tai chi, qi gong and yoga: these therapies improved arthritis pain, joint pain and stiffness; tai chi reduced falls in one study by 47.5 per cent; yoga improved hip extension and stride length, and reduced joint tenderness and hand pain in another study

"The trials we reviewed indicated that mind-body therapies were especially well suited to the older adult with chronic pain," lead author Natalia Morone said in a release. "This was because of their gentle approach, which made them suitable for even the frail older adult. Additionally, their positive emphasis on self-exploration was a potential remedy for the heavy emotional, psychological and social burden that is a hallmark of chronic pain."

The authors note that due to the scarcity of studies on the benefits of such therapies in older people, and the small sample sizes of many of the studies, more evidence about their effectiveness is needed.

"The small numbers of trials of mind-body therapies for chronic pain in the older adult are beginning to shed light on the potential benefits of these interventions," the review. "The many questions they leave unanswered provide ample opportunity for further research."

http://www.cbc.ca/health/story/2007/09/11/healing-pain.html