Review article

Complementary and alternative therapies: what is their place in the management of chronic pain?

The prevalence of depression and anxiety is increasing among the elderly around the world. It is believed that lavender can stabilize the people's mood, so this study was designed to evaluate the effect of lavender on anxiety and depression of the elderly.

This study was a single blind clinical trial with a control group. The participants in the study consisted of 60 elderly subjects (30 in each group) who referred to the Health Center of Larestan city in the south of Iran in 2019. The intervention consisted of using 2 g of lavender teabag, which was prescribed to be used 2 times as decoction in the morning and night. The duration of the intervention was 2 weeks. The eligible participants were randomly assigned to the intervention and control groups using balanced block randomization with a block size of ten. The control group did not receive any placebo. Data collection tools in this study included demographic information questionnaire, Beck Depression and Spiel Berger Anxiety Inventory. Chi-square test and independent t-test were used to analyze the data. The significance level was considered 5 %.

The two groups were similar in terms of age, gender, educational level and marital status and there was no significant difference. The mean score of depression in the intervention group before and after drinking lavender herbal tea was 17.80 ± 1.49 and 16.33 ± 1.49, respectively. The mean score of depression between intervention and control groups after drinking herbal tea were 16.33 ± 1.49 and 18.33 ± 1.84, respectively. This indicated the effect of herbal tea on reducing depression (P < 0.001). Also, mean difference of intervention and control groups after drinking herbal tea in terms of depression and anxiety (state and trait) were (−2.00, 95 % CI (−2.86, −1.13)), (−6.40, 95 % CI (−9.43, −3.36)) and (−4.13, 95 % CI (−7.66, −0.60)), respectively.

The results of the present study showed that consumption of lavender herbal tea can reduce depression and anxiety scores and since it is inexpensive and accessible, it is suggested to be used as a complementary treatment in reducing anxiety and depression.

Effectiveness of music-based interventions (MI) on cancer patients’ anxiety, depression, pain and quality of life (QoL) is a current research theme. MI are highly variable, making it challenging to compare studies. Objective and methods: To summarize the evidence on MI in cancer patients, 40 studies were reviewed following the PRISMA statement. Studies were included if assessing at least one outcome among anxiety, depression, QoL and pain in patients aged ≥ 18, with an active oncological/onco-haematological diagnosis, participating to any kind of Music Therapy (MT), during/after surgery, chemotherapy or radiotherapy.

A positive effect of MI on the outcomes measured was supported. Greater reductions of anxiety and depression were observed in breast cancer patients. MI involving patients admitted to a hospital ward were less effective on QoL.

The increasing evidence about MI effectiveness, tolerability, feasibility and appreciation, supports the need of MI implementation in Oncology, Radiotherapy and Surgery wards, and promotion of knowledge among health operators.

Complementary and alternative medicine (CAM) is commonly used to treat chronic lower back pain. This study aimed to explore CAM use among Turkish patients with chronic lower back pain attending a neuro surgery department hospital.

This cross-sectional study was conducted between September 2015 and January 2016 in the neuro-surgery clinic of the state hospital in Giresun, in northern Turkey. A random sample of patients (n = 182) with at least three months of pain, and whose pain intensity was 3 or higher (on a 0 (without any pain) to 10 (the worst pain possible) scale) were included.

The most frequently used complementary and alternative therapy by patients was prayer (87.4%). Massage was the second most common CAM modality. There was a significant difference between pain intensity and participants’ use of prayer and biofeedback (p < 0.05). Pain intensity was associated with an increased use of prayer and biofeedback (p < 0.05) of patients that used CAM modalities. They also reported greater severity.

The most utilized CAM modality in patients with low back pain was prayer which is classified as a mind-body intervention. Our findings suggest that patients with chronic lower back pain in Turkey tend to use complementary and alternative therapies for pain management.

The use of non-pharmacological techniques for pain relief is increasing among nursing students, because pain is a significant problem that affects the quality of life and everyday activities. The aim of this study was to examine the types of pain experienced by nursing students and the non-pharmacological methods they used to relieve them in Eastern Turkey.

A descriptive survey design was used. This study was carried out in the nursing department of Atatürk University in Erzurum, Turkey. The sampling consisted of 388 students who agreed to participate in the research in the 2010–2011 academic spring term. The data was collected using a questionnaire, which included the demographics of nursing students, questions regarding the types of pain experienced by the students, and the non-pharmacological methods they used in pain control.

Of the 388 students surveyed, 92% experienced pain and 69.1% experienced mostly gastrointestinal symptoms. The types of pain experienced by the students were back and waist (59.3%), throat (45.6%), dysmenorrhoea (44.6%), toothache (41%), neck (33.5%), and tension headaches (33%). The non-pharmacological methods most frequently used were heat application, resting in a dark room, massage, drinking hot herbal beverages, and cold application.

Our conclusion is that students frequently use non-pharmacological interventions. Therefore the nursing education curriculum should include updated information about the use of non-pharmacological interventions and their usefulness.

The aims of this pilot study were to investigate the effects of Healing Touch (HT) on the pain level, joint function, mobility, and depression in persons with osteoarthritis (OA) of the knee joint(s). A randomized controlled trial using a repeated measures design was used. Cognitively intact persons (institutionalized and community) with a diagnosis of OA of the knee joint(s) received either HT sessions three times per week for 6 weeks (n = 12) or weekly friendly visits (FV) (n = 7). The HT sessions were delivered by a team of two nurses certified as HT practitioners and the FV was conducted by a nurse. All subjects continued to receive their standard care including the methods they had been using to relieve their joint pain. The two groups were similar regarding demographic variables, number of knees affected, co-morbidities, pain medications used and outcome variables at baseline. Two pain outcome measures (intensity and life interference) produced significant interaction effects. Two joint outcome measures (extension and extensor lag) also produced significant interaction effects. Furthermore, the HT group demonstrated significant improvements in 9 of the 12 outcome variables (75%) while no significant improvements occurred in the FV group. The HT group exhibited sustained effects (3 weeks post treatments) in three outcome variables. The reduction in joint pain and improvement in joint function suggest that biofield therapies could be effective non-pharmacological adjuncts to treatment of OA.