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Complementary and Integrative Health

Complementary and Integrative Health for Chronic Pain and PTSD: An Overview of Recent Systematic Reviews

by Belle Zaccari, PsyD
Seminar date: 5/16/2024

Description: Background: There are limitations to using front line, evidence based psychotherapies for chronic pain and posttraumatic stress disorder (PTSD). The use of Complementary and Integrative Health (CIH) treatment modalities for these conditions is increasing.

Purpose: The objective of this review of reviews was to summarize the evidence of CIH modalities that can be self-managed and have been trialed for treatment of chronic pain or PTSD.

Study Selection: We included high quality systematic reviews of active, non-pharmacological, non-psychotherapeutic CIH interventions for non-cancer, non-surgical, non-recent injury chronic pain or PTSD published after 2019. We excluded reviews that did not meet this criteria.

Data Extraction: We extracted patient population, interventions, comparators, search dates, outcomes, and number of articles and subjects.

Data Synthesis: Yoga, tai chi, mindfulness, and meditation were included in our sample (N=16); comparators were passive control conditions (e.g. waitlist). For chronic pain (n=8) studies were conducted with mixed populations for treatment of low back pain, knee osteoarthritis, neck pain and “all pain”. Findings of the reviews showed yoga, tai chi, and meditation improve pain intensity and disability as primary outcomes along with benefits to mood/mental health, physical functioning, quality of life, and range of motion. Yoga, meditation and mindfulness were included (n=8) as interventions for PTSD; findings were inconsistent (n=8) for PTSD and other mental health outcomes and quality of life.

Discussion: Active approaches such as mindfulness/meditation, yoga, and tai chi show promise for reducing symptoms of both chronic pain and PTSD. The strength of evidence should be considered when applying these interventions in a stand alone fashion.

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