Does Therapeutic Touch Reduce Pain Free Essays

ABSTRACT: With at least 1.5 million American and 298,000 British patients in theUK diagnosed with cancer, (noted as a leading cause of death), each year, as well as other debilitating diseases, the need for symptom and pain management has become increasingly important. This has been recognised, particularly by nurses within the oncology field. We will write a custom essay sample on Does Therapeutic Touch Reduce Pain? or any similar topic only for you Order Now It has been suggested that alternative, or complementary therapies, such as therapeutic touch, may have the potential to offer health practitioners different means to conventional pharmacologic approaches for the purposes of pain reduction. By analysing some of the latest work in the field, the evidence for whether there is role for therapeutic touch in relieving pain will be evaluated. 1. Introduction Therapeutic touch (TT) is a form of â€Å"energy healing† which was first developed in the 1970s and gained much of its popularity within the American nursing community. The therapy was originally introduced by Dora Kunz (a contemporary healer) and Delores Krieger (Ph.D., R.N.,), a theosophist and nurse, as an alternative to surgical intervention for the purpose of pain relief. There is no scientific basis to TT and thus this practice has been criticised by many sceptics. For the approximately 1.5 million American and 298,000 British patients diagnosed with cancer in the US and UK respectively each year however (PD Sasieni et al., unpublished observations, 2011), TT may offer a viable means of pain reduction and an alternative to more traditional therapy modalities (Jackson, et al., 2008). TT has been heralded as useful in the treatment of such health problems as chronic pain, cancer, multiple sclerosis, thyroid problems and headaches. TT is supported byRogers’ theory of holistic nursing (Rodgers, 1970). This practice has been supported by many health professionals, particularly within the United States (U.S.) and United Kingdom (U.K.). Therapeutic touch relies on the hands as a means of assisting healing (Lafreniere, et al., 1999) and was first introduced by eastern medical practitioners (Kelly, et al., 2004). Nursing is particularly suited to the administration of TT (and other therapeutic techniques) as this branch of health balances treatment of the whole body (termed holistic treatment) against treatment of the disease itself. TT practitioners claim the technique works by adjusting the particularly energy field of the human patient in order to stimulate healing, reduce pain and aid relaxation. TT is based on the concept that humans are â€Å"complex energy fields† continually interconnecting other individual energy fields and those of the surrounding environment. This field is believed to extend from the skins’ surface. With each human at the centre of an energy field, illness is believed, according to the principles of TT, to induce disruption and an imbalance’ in a patients’ energy field, equating to their illness (Hutchinson, et al., 1999). Conversely. a medically healthy person would be considered ‘balanced’ (Jackson, et al., 2008). Practitioners view TT as a means of reparation to the patients’ energy field (Gottlieb, 1995; Krieger, 1979). The following sections will summarise some of the main uses of TT in practice today and present a case for whether TT may be a useful complement to modern pain reduction techniques. 2.1 Therapeutic Touch and Osteoarthritis Osteoarthritis (OA) is a disease that is often seen in older patients and is a prominent cause of disability. Currently, more than 21 million Americans and 8 million British patients and an estimation of 3 in 4 individuals over the age of 75 years are afflicted. OA impairs physical and psychological functions, is chronic in nature and has no established cure (American Pain Society, 2002). Currently prescribed treatments often incur a risk of toxicity, and OA is expensive to treat (CDC, 2006). Thus, alternative effective analgesic treatments, including TT, are being sought. In 1998, a study by Gordon and colleagues looked at 25 patients with knee-bound OA over 4 weeks. Three trials were given; either TT, a control, or mock therapeutic touch (MTT). For pain reduction, such tested parameters as outdoor work, interference and life control, were shown to be higher with TT in relieving OA associated pain, compared with either the control or MTT groups (Gordon, et al., 1998). This promising trial indicated that TT might be effective at considerably reducing pain and improving the patients’ use of the affected areas. 2.2 Therapeutic touch and progressive muscle relaxation Another study pioneered by Peck (1998) involved either the use of TT, or progressive muscle relaxation (PMR) to reduce OA-associated pain in elder patients. The TT and PMR groups both reported improved limb use and overall pain and discomfort reduction. In the trial by Peck (1998), TT specifically improved the use of the patients’ hands whilst walking. A greater overall function of the affected area was seen for the TT group. TT and PMR groups were both shown to improve either hand function or mobility, respectively. 2.3 Further OA of the knee trial using TT 2.3.1 Trial outline A third study by Smith, et al. (2010) looked at three parameters; value of life, functionality of the limb and the effects of TT on pain, in patients coping with OA of the knee. The nature of the study was single-blinded and patients were assigned either a treatment group, (wherein patients could receive two TT therapies twice a week for two months) or sorted into a control group, wherein the patients’ normal treatments were used. Grouping was assigned at random. The three parameters were measured in patients at time 0, 8 weeks and 12 weeks, using the Knee Society Score (KSS),Western Ontarioand McMaster Universities Index (WOMAX) and the Medical Outcomes Study (MOS) Short Form (SF36). 2.3.2 Trial results Although pain is considered to be subjective, it may be defined as an â€Å"unpleasant sensory and emotional experience† (Smith, et al., 2010). On this basis, a noteworthy difference in pain was found between time 0 and 8 weeks, as measured by SF36 (p = 0.009), for limb functionality. The WOMAC scoring additionally revealed statistical differences between 0 weeks and 8 weeks (p = 0.006) and again from 8 weeks to 12 weeks (p = 0.001) in the same parameter. Measurements by the KSS scale revealed pain reduction between weeks 8 to 12, in the treatment comparative with the control group. 2.3.3 Trial conclusion The study by Smith, et al. (2010) indicates the potential for TT, when administered twice a week for 8 weeks for the reduction of OA-associated knee stiffness and pain. However, results from the KSS revealed that patients did not report an effect by TT on knee stability or joint locomotion. There are limitations, however, when calculating the effectiveness of OA related treatments. During the trials, some participants may be liable to discontinue treatment (e.g. Peck (1998)). Furthermore, parameters including environmental humidity, which lie beyond experimental control may introduce experimental bias and thus reduce the reliability of some TT trials. This was the case with the study by Peck (1998), wherein warmer weather alone reduced OA-associated pain. 3. Conclusion The above trials have shown that there is potential for TT in improving knee function in patients suffering from OA (Peck, 1998). TT has been shown to reduce OA-associated symptoms, as well as reducing discomfort and pain associated with cancer and median nerve function (Baird, 2001). Overall, particularly with treatment of chronic illnesses such as cancer, a combination of holistic medicine such as TT and PMR with proven effective conventional medicine is likely to be the most effective means of improving a patients’ condition. These studies reinforce the potential for TT as a useful therapeutic technique. However, further research is necessary to examine more fully the effect of TT on other affected somatic regions, as well as its long-term application as a combined therapy for cancer patients. 4. Bibliography American Pain Society, 2002. Guideline for the management of pain in osteoarthritis, rheumatoid arthritis, and juvenile chronic arthritis. [online] Glenview, IL. (Published 2002) Available at: www.ampainsoc.org/pub/pdf/arthguide.pdf[Accessed 19 February 2011]. Baird, C.L., 2001. First?line Treatment for Osteoarthritis: Part 2: Nonpharmacologic Interventions and Evaluation. Orthopaedic Nursing, 20(6), pp.13-20. CDC, 2006. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2003–2005, MMWR, [online] Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5540a2.htm[Accessed 18 February 2011]. Gordon, A., Merenstein., J.H., D’Amico, F., Judgens, D. 1998. The effects of therapeutic touch on patients with osteoarthritis of the knee. The Journal of Family Practice, 14(4), pp.1-7. Gottlieb, B. ed., 1995. New choices in natural healing. Emmaus, PA: Rodale Press. Hutchinson, C., D’Alessio, B., Forward, J., Newshan, G., 1999. Body-mind-spirit: Healing touch: An energetic approach. American Journal of Nursing, 99(4), pp. 43-48. Jackson, E., Megan, K., McNeil, P., Meyer, E., Schlegel, L., Eaton, M. 2008. Does therapeutic touch help reduce pain and anxiety in patients with cancerClinical Journal of Oncology Nursing, 12(1), pp. 113-120. Lafreniere, K.D., Mutus, B., Cameron, S., Tannous, M., Giannotti, M., Abu-Zahra, H., Laukkanen, E. 1999. Effects of Therapeutic Touch on Biochemical and Mood Indicators in Women. The Journal of Alternative and Complementary Medicine, 5(4), pp. 367-370. Kelly, A.E., Sullivan, P., Fawcett, J., Samarel, N., 2004. Therapeutic Touch, Quiet Time and Dialogue: Perceptions of Women with Breast Cancer. Oncology Nursing Forum, 31(3), pp. 625-631. Krieger, D., 1979. Therapeutic Touch: how to use your hands to help or to heal.New York: Prentice Hall. Peck, S.D.E., 1998. The efficacy of therapeutic touch for improving functional ability in elders with degenerative arthritis. Nursing Science Quarterly, 11(3), pp.123-32. Rodgers, M.E., 1970. Introduction to the theoretical basis of nursing;Philadelphia: F.A. Davis. Smith, A.A., Smith, Kimmel, S., Milz, S., 2010. Effects of Therapeutic Touch on Pain, Function and Well Being in Persons with Osteo-Arthritis of the Knee: A Pilot Study, The Internet Journal of Advanced Nursing Practice, [online] Available at: http://www.ispub.com/journal/the_internet_journal_of_advanced_nursing_practice/volume_10_number_2_11/article/effects-of-therapeutic-touch-on-pain-function-and-well-being-in-persons-with-osteo-arthritis-of-the-knee-a-pilot-study.html [Accessed 17 February 2011]. How to cite Does Therapeutic Touch Reduce Pain?, Essay examples Does Therapeutic Touch reduce pain Free Essays Abstract Pain has a significant negative impact on those who experience it and is not always eased by analgesia. Complementary therapies such as Therapeutic Touch may provide an alternative solution for pain relief. While there have not been many studies into Therapeutic Touch, there is some evidence that it may reduce pain. We will write a custom essay sample on Does Therapeutic Touch reduce pain? or any similar topic only for you Order Now Recent review articles that assessed Therapeutic Touch as a form of pain relief are discussed here. Pain is a common symptom, which is estimated to affect nearly one in five adults in Europe (Fricker, 2003). There are many causes of pain, which can be acute such as following an injury or chronic as is the case in arthritis. Pain not only is a physical symptom, but can affect people’s psychological well being and can have a negative impact on quality of life, not to mention the economic consequences due to lost working days (Ventegodt Merrick, 2005). However, even though the original source may appear to have resolved, pain can linger and does not always respond to conventional medical treatments (Ventegodt Merrick, 2005). For these reasons it is important to explore other therapies as a means of providing pain relief. One such therapy is Therapeutic Touch. Therapeutic Touch is where a therapist consciously uses their hands over a patient’s skin to help balance their energy fields (Rosa et al., 1998). It is based on the theory that there is a two-way flow of energy between any person and their environment and for good health the flows need to be in equilibrium. Tense feelings that can develop from a person’s emotional state can cause tension to build up in muscles, bones, joints and connective tissue, which can act as a blockage to the flow of energy and manifest itself as pain (Ventegodt Merrick, 2005). Therapeutic Touch aims to provide a cure, not through working on individual tissues in the body, but through the person as a whole, enhancing their overall wellbeing (Ventegodt Merrick, 2005). While some hospitals in North America are already using Therapeutic Touch as part of their treatment programmes (So et al., 2008), the use of this complementary approach has not been widely studied. Embracing the concept of evidence based medicine, where therapies need to have demonstrated that they do indeed provide benefit and do not result in any harm, it is important that the effectiveness and safety of Therapeutic Touch is assessed. A Cochrane Review in 2008 assessed 16 studies (either randomised controlled trials or clinical controlled trials) of Therapeutic Touch in relation to pain relief. It found that although a positive result was not seen in all studies, when considered as a whole there was a significant reduction in pain through this therapy, with one study highlighting that Therapeutic Touch may reduce the need for a patient to take analgesia (So et al., 2008). However, this review did highlight the need for further high quality studies in this area, particularly those involving children, as these were not well represented. It also emphasised that although Therapeutic Touch appears a safe therapy, it is still important that studies document any adverse effects. Similar findings to the Cochrane Review were described by a literature review published in the Journal of Holistic Nursing (Monroe, 2009). While only five studies were deemed rigorous enough to be included, the results from four of them showed a significant positive impact of Therapeutic Touch on pain relief, particularly in the management of pain in osteoarthritis, musculoskeletal pain and burns. However, again, further studies were recommended as necessary, including inclusion of a wider range of participants and investigating the effects of treatment frequency, duration and benefit for different types of pain. Little is known about the true mode of action of Therapeutic Touch, so this is another important avenue for further study. Despite not fully consistent results and calls for continued research, interestingly the author recommends that Therapeutic Touch currently be offered as a mode of pain relief, as it is considered to be a safe treatment. Some studies of Therapeutic Touch and pain relief have also explored its benefit on emotional aspects such as depression and anxiety (Lin Taylor, 1998; Marta et al., 2010; McCormack, 2009). While the results of studies have been mixed, some have shown a significant positive impact (Lin Taylor, 1998; Marta et al., 2010), which might be evidence to link the mechanism of Therapeutic Touch for pain relief to its ability to improve emotional wellbeing. A Cochrane Review from 2009 investigating the benefit of Therapeutic Touch on anxiety was not able to conclude anything, as there have not been any well-designed studies for inclusion in an analysis, indicating the need for high quality research in this area (Robinson et al., 2007). One area of Therapeutic Touch studies that has come under criticism is the placebo controls used (Rosa et al., 1998). Unusually the emphasis in Therapeutic Touch is that its efficacy is reliant on the intent of the therapist, so the argument is that the result is less likely to be influenced by the belief of the participant. So traditional placebo controls where the subject is not aware whether or not they are receiving the actual treatment would be inadequate without also the provision of treatment by a sham touch practitioner – they imitate the treatment provided by the true touch therapists but do not alter their state of consciousness (So et al., 2008). While studies which have indicated positive results in relation to pain relief have often been with elderly participants (Lin Taylor, 1998; Marta et al., 2010; McCormack, 2009), this may bring into question whether the benefits may be seen across other age groups. However, as we now live in a time where the demographics are changing towards an ageing population, with people living longer the incidence of chronic disease increases and with many of these pain can be a factor; finding a treatment which may benefit older adults is particularly important (Marta et al., 2010). So in answer to the question posed, there is some indication that Therapeutic Touch aids pain relief, at least in certain patient groups. However, further research will be required before firm conclusions can be drawn and before Therapeutic Touch becomes a mainstream therapy. References: Fricker, J. (2003) Pain in Europe [PDF] Available at: http://www.britishpainsociety.org/Pain%20in%20Europ%20survey%20report.pdf – accessed on 29th April 2012. Lin, Y.S. Taylor, A.G. (1998) Effects of therapeutic touch in reducing pain and anxiety in an elderly population. Integrative Medicine, 1 (4), 155-62. Marta, I.E. et al. (2010) The effectiveness of therapeutic touch on pain, depression and sleep in patients with chronic pain: clinical trial. Revista da Escola de Enfermagem da USP, 44 (4), 1100-6. McCormack, G.L. (2009) Using non-contact therapeutic touch to manage post-surgical pain in the elderly. Occupational Therapy International, 16 (1), 44-56. Monroe, C.M. (2009) The effects of therapeutic touch on pain. Journal of Holistic Nursing, 27 (2), 85-92. Robinson, J. et al. (2007) Therapeutic touch for anxiety disorders. Cochrane Database of Systematic Reviews, 18 (3), CD006240. Rosa, L. et al. (1998) A close look at therapeutic touch. Journal of the American Medical Association, 279 (13), 1005-10. So, P.S. et al. (2008) Touch therapies for pain relief in adults. Cochrane Database of Systematic Reviews, 8 (4), CD006535. Ventegodt, S. Merrick, J. (2005) Clinical holistic medicine: chronic pain in the locomotor system. The Scientific World Journal, 5, 165-72. How to cite Does Therapeutic Touch reduce pain?, Essay examples Does Therapeutic Touch Reduce Pain Free Essays Abstract Many dismiss Complementary and Alternative Medicines such as Therapeutic Touch due to a lack of physiological data accrued from trials (NCCAM, 2000). Therapeutic Touch is considered by those in the field to provide multidimensional effects, not only physiologically, but in thought, feeling, and also spiritually (Leskowitz, 2011). Conventional Controlled Clinical Trials and Randomised Controlled Trials do not consider these additional dimensions, and consequently the results from Therapeutic Touch trials may be severely limited (Fonnebo et al, 2007). We will write a custom essay sample on Does Therapeutic Touch Reduce Pain? or any similar topic only for you Order Now If, however, trials conducted on a multidimensional level were to be considered, the evidence collated would suggest that Therapeutic Touch does reduce pain. Further research into trial methodologies may be required to further support this evidence. Introduction Within the approach of Complementary and Alternative Medicine, Therapeutic Touch falls into the domain of energy or biofield therapies. Therapeutic Touch is a technique by which a practitioner’s hands are used to rebalance the energy field of a patient with the objective of encouraging healing (NCCAM, 2000). Widely practised by many professionals in the health care sector including nurses, occupational therapists, and physical therapists, Therapeutic Touch has been used to induce relaxation, as well as to reduce stress, anxiety, and pain (Winstead-Fry Good, 2009). Conditions and illnesses in which Therapeutic Touch has been used to promote the previous outcomes include: Fibromyalgia Syndrome (Dennison, 2004); chronic pain (Marta et al (2010), Lin (1998); arthritis (Peck (1998), Gordon et al (1998)); cancer (Giasson Bouchard (1998), Aghabati et al (2010), Kelly et al (2004)); Carpal Tunnel Syndrome (Blankfield et al, 2001); post surgical pain (Frank et al (2007), McCormack (2 009)). The success of these applications with regard to pain will be looked at in detail below. Therapeutic Touch and Pain Complementary and Alternative Medicine, of which Therapeutic Touch is included, is widely dismissed, due to its subjective nature and unconventionally scientific foundations (NCCAM, 2000). Trials such as those by Frank et al (2007) and Blankfield et al (2001) provide support for these claims as it was found that there was no measured decrease in pain felt by those participants receiving Therapeutic Touch therapy, and that Therapeutic Touch may be dismissed as placebo. Contrary to this dismissal, (Fonnebo et al, 2007)argues that the conventional approach to achieving acknowledgement in new areas of medical science through controlled randomised trials, generally using a placebo as a control, is not suitable for generating evidence in this area of medicine. In this instance, practises are often simplified causing limitations in data available for collection and analysis, thus restricting any attainable conclusions. Further to the case of (Fonnebo et al, 2007), Leskowitz (2011) argues that Complementary and Alternative Medicine not only promote physiological benefits, but can provide additional benefits in the form of emotions, thoughts, and also spiritually, all of which are dismissed in conventional medical trials. If trials incorporating these additional dimensions were, however, to be regarded as clear evidence for the case of Complementary and Alternative Medicine and hence Therapeutic Touch, a significant amount of data may be accrued, as shown below. The following reputable electronic databases were searched to gather information including: The Cochrane Library, PubMed, JStor, Science Direct, and others. Examples of Randomised Controlled Trials, or Controlled Clinical Trials were used to evaluate the effect of Therapeutic Touch on pain. Further to this, trials using pain measurement tools and methods recognised and used in conventional medicine were similarly taken into consideration: visual analogue scales, numerical rating scales, verbal rating scales, McGill Pain Questionnaire, Brief Pain Inventory (Caraceni et al, 2002). In 2010, Aghabati et al conducted a trial, consisting of 90 cancer patients, to evaluate the effects of Therapeutic Touch on pain. The results of this trial saw a significant reduction in pain of those participants receiving Therapeutic Touch in comparison to those participants in the control group who received customary care. In an equally sized trial of 90 patients experiencing post-surgical pain, McCormack (2009) found that Therapeutic Touch decreased pain in participants more so than in those not receiving Therapeutic Touch. Two further trials of similar size also concluded a distinctly greater reduction in pain when compared to those in the control group not receiving Therapeutic Touch (Lin (1998), Turner et al 1998). Similarly, in smaller trials, significant improvements were felt as a result of Therapeutic Touch therapy (Dennison (2004), Marta et al (2010), Gordon et al (1998). In addition to these trials displaying positive reductions in pain as a result of Therapeutic Touch, it can be argued that trials which consider pain on a broader plain may also be considered when evaluating the effects of Therapeutic Touch; for example trials measuring subjective feelings and thoughts associated with a reduction in pain, such as anxiety, tension, well-being, calmness, relaxation, and mood. Trials by Lafreniere et al (1999), Peck (1998), Giasson Bouchard (1998), and Kelly et al (2004) using multidimensional measurements concluded that that Therapeutic Touch had a marked improvement in these feelings. Conclusion The scientific design and consequential limitations of conventional randomised clinical trials have resulted in the dismissal of Complementary and Alternative Medicine such as Therapeutic Touch as an effective treatment in the reduction of pain. However, if other dimensions (emotional, philosophical, and spiritual) were to be taken in to consideration then much more evidence, as the trials above illustrate, could validate the claim that Therapeutic Touch is effective in reducing pain. Therefore, considering the evidence gathered it is concluded that on a multidimensional level, there is sufficient evidence here to suggest that Therapeutic Touch can reduce pain, and that provision in clinical trials is required to further substantiate, or negate these claims. References Aghabati, N. Mohammadi, E. Pour Esmaiel, Z. (2010) The effect of therapeutic touch on pain and fatigue of cancer patients undergoing chemotherapy. 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BMC Medical Research Methodology [online]. 7(7) 239-255 Available from: http://www.masterpaliativos.com/ArchivosFTP/BackupXII/course_files/Taller_Dolor_Octubre_2010/Documentacion_complementaria/Pain_measurement_EAPC.pdf [date accessed 15.05.12] Frank, L.S. Frank, J.L. March, D. Makari-Judson, G. Barham, R.B. Mertens, W.C. (2007) Does therapeutic touch ease the discomfort or distress of patients undergoing stereotactic core breast biopsyA randomized clinical trial. Pain medicine [online] 8(5): 419-424 Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/928/CN-00610928/frame.html [date accessed 15.05.12] Giasson, M. Bouchard, L. (1998) Effect of therapeutic touch on the well-being of persons with terminal cancer. Journal Holistic Nursing [online] 16(3):383-398. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9849260 [date accessed 15.05.12] Gordon, A. Merenstein J.H. D’Amico, F. Hudgens, D. 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Energy Medicine East and West [online] 283-288 Available from: http://www.sciencedirect.com/science/article/pii/B9780702035715000226 [date accessed 15.07.12] Lin, Y. (1998) Effects of therapeutic touch in reducing pain and anxiety in an elderly population. Integrative Medicine. [online] 1(4):155-162 Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/491/CN-00292491/frame.html [date accessed 15.05.12] Marta, I.E. Baldan, S.S. Berton, A.F. Pavam, M. da Silva, M.J. (2010) The effectiveness of therapeutic touch on pain, depression and sleep in patients with chronic pain: clinical trial. Revista da Escola de Enfermagem da U S P [online] 44(4):1100-1106. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/880/CN-00778880/frame.html [date accessed 15.07.12] McCormack, G.L. (2009) Using non-contact therapeutic touch to manage post-surgical pain in the elderly. 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Journal of advanced nursing [online] 20(1): 10-20 Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/884/CN-00685884/frame.html [date accessed 15.05.12] Winstead-Fry, P. Good, R. (2009) Therapeutic Touch in the treatment of fibromyalgia. Fibromyalgia Syndrome — A Practitioner’s Guide to Treatment [online] 279-288. Available from: http://www.sciencedirect.com/science/article/pii/B9780443069369000123 [date accessed 15.07.12] How to cite Does Therapeutic Touch Reduce Pain?, Essay examples