Non-Narcotic Therapies for Pain Management

Nanette Brown

Karen Bowers

Laura Parker

Kathy Vietti

Alternative Medicine

• http://www.youtube.com/watch?v=L8uqepK6muU&list=PLBxTgKdXhzxoa-eFDD2TH7kyNsTn84E4V&index=1

The Questions

• What alternative /non narcotic treatments for pain are available?

• What are the most effective complementary alternative medicine s (CAMs) for pain control?

Pain Statistics

• 1 in 6 Americans have chronic pain.

• It is estimated that $120 billion is spent on medical care and lost productivity.

• 50 million sick days per year in the United States.

• Less than 6000 providers have formal training in pain management (McCarberg 2007)

Treatment Caveats

• Thorough pain assessment/history.

• Restoration of functionality to an acceptable level (McCarberg, 2007)

• Individualized

Self Treatment with CAMs

• 595 participants

• Minimal differences in pain ratings

• Participants reported 45% reduction in pain

• 76% used CAMs

• 28% used herbals or supplements

• 31% failed to inform their provider (Vallerand , 2002)

Music Therapy

• The fear of pain is ranked second only after the fear of death

• Music is a non-pharmacological/nonchemical method

• Music interventions have been used to promote patients health and well-being by nurses(Engall., Sorensen Duppils 2009)

Purpose of the Research Review

• Effect of music intervention on postoperative pain

• Methods used to measure that effect

• Type of surgery, group design, music and music selection, instructions and manipulation of the environment and the time of the intervention(Engall., Sorensen Duppils 2009)

Study Methods

• Eighteen studies in the review

• Total of 1,604 patients were involved in the study

• Studies were performed in the USA, Sweden, Japan, Hong Kong, China and Taiwan

• The design of the study was different by type of procedure and music selection(Engall., Sorensen Duppils 2009)

Music and Music Selection

• Relaxing and calming et: sea waves

• Soft classical

• Piano, harp, synthesizer

• Classical

• Jazz

• Mozart

• Music selection was either selected by the investigator, subject or harpist (Engall., Sorensen Duppils 2009)

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Research Conclusion

• Music can be used as an adjuvant for the relief of postoperative pain

• Music has the power to enhance distraction and well-being as a psychological support and increase relaxation

• Music intervention alleviates postoperative pain

• Due to the small sample size , further studies are needed (Engall., Sorensen Duppils 2009)

Massage Therapy

• Most popular complementary therapy

• Human touch

• Pain relief and relaxation

Massage Therapy

• Reduces anxiety & stress

• Improves sleep and emotional well being

• Lowers blood pressure

• Reduces pain

• Promotes healing process

Massage Therapy

• Major improvement of decreasing pain levels mean pain levels pre-massage 5.18 post-massage 2.33

• Evidence based research noted importance of human touch to balance today’s high technology

• Promotes recovery and the healing process

Herbal Therapy

• Referred to as botanical medicine or phytomedicine

• The parts of the plant used for making medicine are the seeds, berries, roots, leaves, bark, or flowers

• The World Health Organization estimated that 80% of people worldwide are using herbal therapies as part of their primary health care

Herbal Therapy

• Prescribed for Osteoarthritis due to the anti-inflammatory and circulatory stimulant effect

• Desired effect of the therapy is a decrease in level of pain and inflammation

Herbal Therapy

Study Objectives

• Ginger

• Effectiveness of therapy in decreasing severity of joint pain

• Improving quality of life and improving physical function

• Safety of administration/adverse effects

Herbal Therapy

• Systemic review of studies done on effectiveness of therapy

• Data extraction was done using the Joanna Briggs Institute methods of abstraction

• Inconsistent results identified in the past studies

• Identifies need for further nursing research needed in this topic

Conclusion

• Limited nursing research available

• Identified multiple topics for future nursing studies

• Opportunities for nurse practitioners to incorporate these therapies

Analysis

• Nurses have the ability to use other methods for pain control

• Increase educational opportunities such as in-services, conferences, Continuing Educational Units(CEU’s)

• Increase community awareness

• Health fairs

• Hospital sponsored event

• College based curriculum for nursing students

References

• University of Maryland Medical Center(2011) Herbal Medicine. Retrieved from: http://www.umm.edu/altmed/articles/herbal-medicine-000351.htm

• Leach, M., & Kumar, S. (2008). The clinical effectiveness of ginger (Zingiber officinale) in adults with osteoarthritis. International Journal of Evidence Based Healthcare ,6, 311-320. Retrieved from http://doi:10.1111/j.1479-6988.2008.00106.x

• Chadzopulu, A., Dimitrakaki, P., Filintras, I., Galanis, P., Gkika, D., & Theodosopoulou, E. (2011). Patient and nurses attitude towards pain management with alternative methods. Progress in Health sciences 1.2. Retrieved from Health Reference Center Academic Database.

• Engwall, M., & Sorensen Dupopils G. (2009). Music as a Nursing Intervention for Postoperative Pain: A Systematic Review. Journal of PeriAnesthesia Nursing, Vol 24, No 6(December), 2009: pp 370-383. Retrieved from :http://journals.elsevierhealth.com/periodicals/yjpan/article/S1089-9472(09)00406-7/fulltext

• Adams, R., White, B, Beckett, C.,(2010). The effects of massage therapy on pain management in the acute care setting. International Journal of Therapeutic Massage and Bodywork: Research, Education, and Practice, 3,(1).

• Vallet, M., (2012). Massage lupus. Massage Therapy Journal. Massage Therapy Journal, 51.1

References

• McCarberg, B., & D'Arcy, Y. (2007). Target pain with topical peripheral analgesics. Nurse Practitioner, 32(7), 44-49

• Vallerand, A., Fouladbakhsh, J., & Templin, T. (2003). The use of complementary/alternative medicine therapies for the self-treatment of pain among residents of urban, suburban, and rural communities. American Journal Of Public Health, 93(6), 923-925. doi:http://0-dx.doi.org.libcat.ferris.edu/10.2105/AJPH.93.6.923