Complementary approaches such as meditation help patients manage chronic pain

Complementary practices such as meditation and mindful breathing helped patients manage chronic pain and in some cases reduced the need for medication such as opioids, according to a study at Hospital for Special Surgery (HSS) in New York City.

The research, "Complementary Practices as Alternatives to Pain: Effectiveness of a Pain Management Program for Patients in an Orthopedic Clinic," was presented at the American College of Rheumatology/Association of Rheumatology Health Professionals annual meeting on October 24 in Chicago.

"Opioid misuse and addiction are a major public health issue in the United States, and approximately 70 percent of individuals who use opioids on a long-term basis have a musculoskeletal disorder, such as low back pain or arthritis," said Maggie Wimmer, coordinator of Programs and Outcomes, Public and Patient Education at HSS. "To address this epidemic, Hospital for Special Surgery implemented a Pain and Stress Management program in its orthopedic clinic to enhance patient knowledge and encourage complementary practices as alternatives to medication."

HSS launched the pilot program in March 2017 for patients at the hospital's Ambulatory Care Center, which serves a low income, diverse community living with chronic musculoskeletal conditions. Reaching 122 participants, the program included a monthly workshop led by a meditation instructor and a social worker, as well as a weekly meditation conference call. Participants engaged in mindful breathing techniques and meditation to manage chronic pain and stress.

To evaluate the program, researchers surveyed participants after each monthly meeting. Data was collected to assess program effectiveness, participants' knowledge of complementary practices, how often they used the techniques, and how the practices helped them cope with pain and stress.

Researchers reported the following:

• 98 percent strongly agreed/agreed that they were satisfied with the program.
• 95 percent said the program increased their understanding of complementary treatments and the ability to apply the techniques to manage pain and stress.
• 93 percent indicated that they would recommend the program to others.
• One out of three participants reported using the alternative techniques five or more times in the previous week in place of medication, and 11 percent used the techniques three to four times in place of medication.
• More than half of the participants indicated that mindful breathing helped them manage their chronic pain and stress.

The debriefings conducted by the social worker during the monthly sessions also revealed that in addition to reduced pain and stress, many participants experienced improved daily function, calmness and improved state of mind after using the techniques.

Comments from participants recorded by the social worker include:

• "It's not just pills that help with pain; you can do it with your mind."
• "I learned how to breathe; it relieved my pain."
• "It was very calming, and it helped."
• "The stillness gives the body time to rebalance itself."
• "I feel less anxious, and it was very relaxing. The mind is a powerful tool".

"The results indicate that alternative approaches are effective in reducing pain and stress, and in improving self-management and general well-being," said Robyn Wiesel, associate director, Public and Patient Education at HSS. "Based on the success of the Pain and Stress Management program in the orthopedic clinic, it has been expanded to include patients in the HSS Rheumatology Clinic, many of whom rely on opioid medication to manage chronic pain."