Back and Neck Pain
Pain, along with fatigue, is the most common complaint heard by any physician or primary health care professional. Chronic pain is pain that persists beyond the length expected from an injury, and can become a difficult problem in itself. A good deal of medical research shows that many people can reduce or relieve pain successfully with relaxation and guided imagery. Our Pain Relief CD will teach you three frequently effective methods of reducing pain through the mind/body connection, and the Guided Imagery for Self-Healing book and 4 CD set will teach you all the fundamental skills of using guided imagery to help stimulate healing from within. The book will explain the process, review the science behind it, and coach you through the common questions that people have, while the CD set guides you through the 9 essential guided imagery skills taught in the book. We recommend reading the book no matter what CDs you choose, but if you prefer to just listen rather than read, you may want to start with Self Healing with Guided Imagery, a 2 CD set featuring Dr. Andrew Weil. The first CD explains mind/body healing and guided imagery while the second teaches you three self-healing skills.
Back pain is one of the most common and disabling problems seen by any health professional. Over 80% of all Americans will have significant back pain at some time in their life, whether from posture, stress and tension, sprains and injuries, or herniated disks. Medical research shows that relaxation and guided imagery can be very helpful with back problems, reducing muscle tension and spasms, pain, and stress effects that can both cause or be caused by back problems. Our Guided Imagery for Self-Healing book and 4 CD set will teach you all the fundamental skills of using guided imagery to help stimulate healing from within. The book will explain the process, review the science behind it, and coach you through the common questions that people have, while the CD set guides you through the 9 essential guided imagery skills taught in the book. If you prefer to listen rather than read, you may want to start with Self-Healing with Guided Imagery, a 2 CD set featuring Dr. Andrew Weil. The first CD explains mind/body healing and guided imagery while the second teaches you three self-healing skills. Some people prefer to start with our Pain Relief CD or add it to the set to learn additional guided imagery skills specifically aimed at reducing or relieving pain.
RESEARCH
Guided Imagery for neck and back pain
November, 2005
Incidence of Back and Neck Pain
Fifteen to twenty percent of Americans have back pain at any given time, and 70% have had back pain at least once in their lives (Atlas, Deyo, 2001; Lipman, Jackson, 2000). According to the American Academy of Physical Medicine and Rehabilitation, back pain is the second leading cause of absenteeism from work. Work-related back injuries are the country’s number one occupational hazard, with the cost to Americans of lower back pain given as $50 billion a year (NINDS). According to government statistics, there were 14.3 million office visits for conditions associated with back pain (Hart, Deyo, Cherkin, 1995). In 1997, almost one-third (or 203 million) of all visits to CAM providers were for back or neck pain (Wolsko, Eisenberg, Davis, Kessler, Phillips, 2003).
Chronic pain can have negative psychological side effects such as anger, anxiety, depression, low perceived quality of life, low self-efficacy, and poor coping skills (Materson, 1999).
Mind-Body Approaches
Many studies demonstrate the effectiveness of cognitive-behavioral measures, including relaxation, meditation, and guided imagery, in reducing pain perception, narcotic use, and physician visits, and in increasing feelings of self-efficacy and well-being in pain conditions. Researches in one study of people with neck and back pain found that cognitive-behavioral therapy that included relaxation and imagery stopped pain from becoming a chronic disability in 88% of the cases (Linton, Andersson, 2002). The noted authority on Preventive and Behavioral Medicine, Jon Kabat-Zinn, found that mindfulness meditation successfully reduced pain in a mixed group of chronic pain patients, including those with back pain; the location of pain did not appear to affect the outcome (Kabat-Zinn, Lipworth, Burney, 1985).
In a 2003 extensive review by Astin et al. of mind-body literature, researchers concluded “there is considerable evidence” that these approaches (imagery, relaxation, CBT meditation, imagery, and hypnosis) are effective in the treating chronic lower back pain (Astin, Shapiro, Eisenberg, Forys, 2003). Astin's 2004 review also reaffirmed that "multi-component mind-body approaches" are an suitable adjunctive treatment for chronic low back pain (Astin, 2004). A 2005 review published in Cochrane Database System Review found strong evidence for CBT's having a "medium positive effect" on pain, and moderate evidence of progressive relaxation's having a "large positive effect on pain and behavioural outcomes"; however, it was inconclusive as to whether these effects were long term (Ostelo, vanTulder, Vlaeyen, Linton, Morley, Assendfelft, 2005).
Another study reported that a higher percentage of patients had used complementary therapies for their back and neck pain than had used conventional approaches (54% vs. 37%). A higher percentage of those using complementary methods found those approaches “more helpful” than those who used conventional approaches (Wolsko, Eisenberg, Davis, Kessler, Phillips, 2003).
A three-year follow up study of back and neck pain patients revealed that a program of behavioral medicine cut sick leave by almost two-thirds (Jensen, Bergstron, Ljungquist, Bodin, 2005). Another multidisciplinary approach (which included relaxation) was also deemed effective in significantly reducing sick leave (Storro, Moel, Sveback, 2004). Patients using a program of breath therapy (body awareness, movement, breathing, and meditation) improve significantly both physically and emotionally (Mehling, Hamel, Acree, Myl, Hecht, 2005). Meditation was able to reduce not only pain, but also anger and psychological distress in those with chronic low back pain (Carson, Keefe, Lunch, Carson, GOli, Fras, Thorp, 2005. Among other complementary approaches, patients using Iyengar yoga had a high compliance rate, and showed significant improvements in pain, function, and medication use (Williams, Petronis, Smith, Goodrich, Wu, et al., 2005).
Chronic neck pain can accompany chronic headache. In a study of the use of imagery in patients with tension headache patients (Mannix, Chandurkar, Rybicki, Tusek, Solomon, 1999), the imagery group was three times as likely to report major pain reduction (p=.004.) Relaxation and imagery has significantly reduced pain in studies involving patients with cancer, arthritis, fibromyalgia, hemophilia, and migraine headaches (Syrjala, Donaldson, Davis, Kippes, Carr, 1995; Varni, Gilbert, 1982; Walco, Ilowite, 1992). In all studies with follow-up, improvements in pain, function, and mental outlook were sustained through follow-up lasting as long as 18 months (Materson, 1999; Linton, Andersson, 2002; Kabat-Zinn, Lipworth, Burney, 1985).
REFERENCES
Astin, A. Mind-body therapies for the management of pain. Clin J Pain. 2004 Jan-Feb;20(1):27-32.
Astin, J.A., Shapiro, S.L., Eisenberg, D.M., Forys, K.L. (2003). Mind-body medicine: state of the science, implications for practice. J Am Board Fam Pract., Mar-Apr;16(2):131-47.
Atlas, S.J., Deyo, R.A. (2001). Evaluating and managing acute low back pain in the primary care setting. J Gen Intern Med,;16:120–31.
American Academy of Physical Medicine and Rehabilitation. http://www.aapmr.org/condtreat/pain/lowback.htm Accessed November 2005. Carson JW, Keefe FJ, Lynch TR, Carson KM, Goli V, Fras AM, Thorp SR. Loving-kindness meditation for chronic low back pain: results from a pilot trial. J Holist Nurs. 2005 Sep;23(3):287-304; discussion 305-9.
Hart LG, Deyo RA, Cherkin DC. (1995). Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine, Jan 1;20(1):11-9.
Jensen IB, Bergstrom G, Ljungquist T, Bodin L. A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain. Pain. 2005 Jun;115(3):273-83. Epub 2005 Apr 19.
Kabat-Zinn, J., Lipworth, L., Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain.” Journal of Behavioral Medicine, June; 8(2):163-90.
Linton S.J., Andersson, T. (2002) Can chronic disability be prevented? A randomized trial of cognitive-behavior intervention and two forms of information for patients with spinal pain.” Spine, Nov 1; 25(21): 2825-31.
Lipman, A.G., Jackson, K.C. II. (2000). Headache and muscle and joint pain. In: Handbook of Nonprescription Drugs. 12th ed. Washington, DC: American Pharmaceutical Association; 2000:41–76.
Mannix LK, Chandurkar RS, Rybicki LA, Tusek DL, Solomon GD. (1999). Effect of guided imagery on quality of life for patients with chronic tension-type headache. Headache, May;39(5):326-34.
Materson, R. (1999). “The Stress-Pain Relationship.” The Pain Practitioner, Winter 9(4).
Mehling WE, Hamel KA, Acree M, Byl N, Hecht FM. Randomized, controlled trial of breath therapy for patients with chronic low-back pain. Altern Ther Health Med. 2005 Jul-Aug;11(4):44-52.
National Institute of Neurological Disorders and Stroke. www.ninds.nih.gov/health_and_medical/pubs/back_pain.htm Accessed November, 2005.
Osteki RWm van Tulder MW, Vlaeyen JW, Linton SJ, Morley SJ, Assendelft WJ. Behavioural treatment for chronic low-back pain. Cochrane Database Syst Rev. 2005 25;(1):CD002014.
Syrjala, K.L., Donaldson, G.W., Davis, M.W., Kippes, M.E., Carr, J.E. (1995). Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain, Nov;63(2):189-98.
Storro S, Moen J. Svebak S. Effects of sick-leave of a multidisciplinary rehabilitation programme for chronic low back, neck or shoulder pain: comparison with usual treatment. J Rehabil Med. 2004 Jan;36(1):12-6.
Varni, J.W., Gilbert, A. (1982). Self-regulation of chronic arthritic pain and long-term analgesic dependence in a haemophiliac. Rheumatol Rehabil, Aug;21(3):171-4.
Walco, G.A., Ilowite, N.T. (1992). Cognitive-behavioral intervention for juvenile primary fibromyalgia syndrome. J Rheumatol, Oct;19(10):1617-9.
Williams KA, Petronis J, Smith D, Goodrich D, Wu J, Ravi N, Doyle EJ Jr, Gregory Juckett R, Munoz Kolar M, Gross R, Steinberg L. Effect of Iyengar yoga therapy for chronic low back pain. Pain. 2005 May;115(1-2):107-17.
Wolsko, P.M., Eisenberg, D.M., Davis, R.B., Kessler, R., Phillips, R.S. (2003). Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine, Feb 1;28(3):292-7.
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