Guided imagery for musculoskeletal pain: A systematic review
ABSTRACT The objective of this systematic review was to assess the effectiveness of guided imagery (GI) as a treatment option for musculoskeletal pain (MSP).
Six databases were searched from their inception to May 2010. All controlled clinical trials were considered, if they investigated GI in patients with any MSP in any anatomic location and if they assessed pain as an outcome measure. Trials of motor imagery were excluded. The selection of studies, data extraction, and validation were performed independently by 2 reviewers.
Nine randomized clinical trials (RCTs) met the inclusion criteria. Their methodologic quality ranged between 1 and 3 on the Jadad scale. Eight RCTs suggested that GI leads to a significant reduction of MSP. One RCT indicated no change in MSP in comparison with usual care.
It is concluded that there are too few rigorous RCTs testing the effectiveness of GI in the management of MSP. Therefore, the evidence that GI alleviates MSP is encouraging but inconclusive.
- SourceAvailable from: Egil A Fors
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- "Guided imagery also appeared as a resilience factor in this 14 years follow-up of the Fors et al. 2002 study , which supports findings that relaxation, imagery and cognitive training may predict reductions in pain compared to untreated patients . Syrjala et al.  and van Kuiken et al.  have revealed results which show that guided imagery have positive effects the first five to seven weeks after treatment, but that the effects seem to yield after 18 weeks  in reducing persistent pain [19,62], but it has not been investigated in a long-term prospective studies previously. "
ABSTRACT: Background Little is known about contextual effects on chronic pain, and how vulnerability factors influence pain in different contexts. We wanted to examine if fibromyalgia (FM) pain varied between two social contexts, i.e. at home versus in a doctor office, when it was measured the same day, and if pain was stable for 14 years when measured in similar contexts (doctor office). Our secondary aim was to explore if pain vulnerability factors varied in the two different contexts. Findings Fifty-five female FM patients were included in the study and scored pain in both contexts at baseline. Their age ranged between 21–68 years (mean 45.7), mean education level was 11 years and mean FM-duration was 15.6 years. Their mean pain was perceived significantly lower at home than in a doctor context the same day. However, pain was much more stable when measured in two similar contexts 14 year apart where 30 subjects (54.5%) completed. Predictor analyses revealed that pain vulnerability factors apparently varied by home and doctor contexts. Conclusion Pain and pain predictors seem to vary by contexts and time, with less pain at home than to a doctor the same day, but with unchanged pain in the same context after 14 years. Thus, contextual pain cues should be accounted for when pain is measured and treated, e.g. by focusing more on home-measured pain and by optimizing the doctor office context. This explorative study should be followed up by a larger full-scale study.BMC Research Notes 11/2012; 5(1):644. DOI:10.1186/1756-0500-5-644
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ABSTRACT: A large number of studies have provided evidence for the efficacy of psychological and other non-pharmacological interventions in the treatment of chronic pain. While these methods are increasingly used to treat pain, remarkably few studies focused on the exploration of their neural correlates. The aim of this article was to review the findings from neuroimaging studies that evaluated the neural response to distraction-based techniques, cognitive behavioral therapy (CBT), clinical hypnosis, mental imagery, physical therapy/exercise, biofeedback, and mirror therapy. To date, the results from studies that used neuroimaging to evaluate these methods have not been conclusive and the experimental methods have been suboptimal for assessing clinical pain. Still, several different psychological and non-pharmacological treatment modalities were associated with increased pain-related activations of executive cognitive brain regions, such as the ventral- and dorsolateral prefrontal cortex. There was also evidence for decreased pain-related activations in afferent pain regions and limbic structures. If future studies will address the technical and methodological challenges of today's experiments, neuroimaging might have the potential of segregating the neural mechanisms of different treatment interventions and elucidate predictive and mediating factors for successful treatment outcomes. Evaluations of treatment-related brain changes (functional and structural) might also allow for sub-grouping of patients and help to develop individualized treatments.Neuroscience Letters 03/2012; 520(2):156-64. DOI:10.1016/j.neulet.2012.03.010 · 2.06 Impact Factor