Spiritual knowledge and practices to conquer chronic pain: A systematic review

Abstract

Understanding of pain as multidimensional experience has improved quality of life of many sufferings from chronic pain. Addressing spiritual dimension in chronic pain patients can improve outcome. The purpose of the present study was to systematically review literature from 1994 to 2018 using PubMed search engine to correlate between spirituality and pain management. The review included 25 randomized controlled trials (RCT). Positive correlation with spiritual healing was proved in 7 RCTs that included patients of idiopathic chronic pain syndromes. Patients with cancer pain, showed improvement in quality of life, visual analog scores with various spiritual techniques in 4 out of 6 RCTs. Pray meditation was recommended as one of management techniques for reducing pain after cesarean surgery in 1 RCT. Migraine medication usage decreased in spiritual meditation group improving the pain tolerance with significant improvements in anxiety, depression, and reduction in muscle tension in 3 RCTs. A study of cognitive behavioral therapy of 8 weeks, done in fibromyalgia patients recommended second generation mindfulness as a therapy to control their symptomatology in 1 RCT. In 2 RCTs involving students, the cold pressor task and the length of cold immersion seemed to be longer in those receiving spiritual intervention. One RCT, involving hospitalized patients concluded that spiritual healing was effective in promoting a state of muscle relaxation, reducing anxiety and depression, and raising the perceptions of wellness in patients. In a RCT involving chronically ill patients, encouraging spiritual coping was associated with better psychosocial and health outcome. Three RCTS involving patients of rheumatoid arthritis, neurofibromatosis, and chronic pain states not responding to conventional therapy did not show any significant correlation with spiritual intervention. Pain physicians can use better understanding of spiritual knowledge with non-pharmacotherapy techniques.