An Analysis of the Various Chronic Pain Conditions Captured in a Systematic Review of Active Self-Care Complementary and Integrative Medicine Therapies for the Management of Chronic Pain Symptoms
- Disclosures: The authors report no conflicts of interest. The authors have not presented these data and information before in any journal or presentation and have no professional relationships with companies or manufacturers who will benefit from the results of this present study. This material is based upon work supported by the US Army Medical Research and Materiel Command under Award Nos. W81XWH-08-1-0615 and W81XWH-10-1-0938. Any opinions, findings and conclusions, or recommendations expressed in this material are those of the author(s) and should not be construed as an official Department of Defense, Department of the Army, or Uniformed Services University of the Health Sciences position, policy, or decision unless so designated by other documentation.
Chronic pain management typically consists of prescription medications or provider-based, behavioral, or interventional procedures that are often ineffective, may be costly, and can be associated with undesirable side effects. Because chronic pain affects the whole person (body, mind, and spirit), patient-centered complementary and integrative medicine (CIM) therapies that acknowledge the patients' roles in their own healing processes have the potential to provide more efficient and comprehensive chronic pain management. Active self-care CIM therapies (ACT-CIM) allow for a more diverse, patient-centered treatment of complex symptoms, promote self-management, and are relatively safe and cost-effective. To date, there are no systematic reviews examining the full range of ACT-CIM used for chronic pain symptom management.
A systematic review was conducted, using Samueli Institute's rapid evidence assessment of the literature (REAL©) methodology, to rigorously assess both the quality of the research on ACT-CIM modalities and the evidence for their efficacy and effectiveness in treating chronic pain symptoms. A working group of subject matter experts was also convened to evaluate the overall literature pool and develop recommendations for the use and implementation of these modalities.
Following key database searches, 146 randomized controlled trials, covering 33 different pain conditions, were included in the review.
This article categorized studies by pain condition, describing the diagnostic criteria used and modalities that seem most effective for each condition. Complexities associated with investigating chronic pain populations are also discussed. The entire scope of the review, categorized by modality rather than pain condition, is detailed throughout the current Pain Medicine supplement.