Non-Narcotic Therapies for Pain Management
Nanette BrownKaren BowersLaura ParkerKathy 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)• •
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