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Mind-body interventions for chronic pain in older adults: a structured review

19 Jul

A review of the research literature was conducted by investigators from the University of Pittsburgh, looking at eight mind-body interventions for older adults with chronic, nonmalignant pain, to see if these methods were feasible, safe or effective at reducing pain.

The interventions targeted for the study were biofeedback, progressive muscle relaxation, meditation, guided imagery, hypnosis, tai chi, qi gong, and yoga.

Of 381 articles retrieved through searches in in the MEDLINE, PsycINFO, AMED, and CINAHL, there were 20 trials that included older adults with chronic pain.

Fourteen articles included participants aged 50 years and above, while only two of these focused specifically on persons aged >/=65 years. An additional six articles included persons aged >/=50 years. Fourteen articles were controlled trials.

There is some support for the efficacy of progressive muscle relaxation plus guided imagery for osteoarthritis pain. There is limited support for meditation and tai chi for improving function or coping in older adults with low back pain or osteoarthritis. In an uncontrolled biofeedback trial that stratified by age group, both older and younger adults had significant reductions in pain following the intervention. Several studies included older adults, but did not analyze benefits by age. Tai chi, yoga, hypnosis, and progressive muscle relaxation were significantly associated with pain reduction in these studies.

The reviewers conclude that the eight mind-body interventions reviewed are feasible in an older population. They are likely safe, but many of the therapies included modifications tailored for older adults. There is not yet sufficient evidence to conclude that these eight mind-body interventions reduce chronic nonmalignant pain in older adults. Further research should focus on larger, clinical trials of mind-body interventions to answer this question.

Citation: Morone NE, Greco CM. Mind-body interventions for chronic pain in older adults: a structured review. Pain Med. 2007 May; 8 (4): pages 359-75.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award