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SANDUSKY, OH – Local Study Published on Use of Therapeutic Touch to Relieve Arthritic Pain

May 3, 2010

Lumpia, shown here under construction, are Filipino pastries similar to spring rolls. Also note arthritic hands consistent with osteoarthritis, common wear and tear with aging. Photo by Paul Goyette http://flickr.com/photos/pgoyette/102438517/

Dr Ann Smith, of Huron, professor emeritus at the College of Nursing, University of Toledo, has published an article in the current issue of the Internet Journal of Advanced Practice Nursing. The article is the result of a study conducted by Ann Smith, PhD and Sanford Kimmel, MD of Toledo. Their study finds that people with arthritis in the knees who receive Therapeutic Touch twice a week experience significant relief of pain and improved ability to perform daily activities. Subjects who received treatment were able to more easily walk, climb stairs, and do housework after treatments.

Therapeutic Touch is a healing energy therapy in which the therapist helps to balance the person’s energy and to elicit deep relaxation. The study found that Therapeutic Touch produced relief of pain and that it had a prolonged effect after treatments ended.

Dr Smith has taught at the Sandusky School of Practical Nursing, Owen’s Technical College, Lourdes College, and the College of Nursing at the University of Toledo. She now practices at the Reiki and Counseling Center in Sandusky, Ohio. Phone: 419-503-0906, Web: http://centerforhealth.smithdocs.net/index.html.

Introduction

Osteoarthritis (OA) is a leading cause of chronic disability that increases with age and affects more than 21 million Americans (1). This disease produces pain that impairs physical and psychological function and affects quality of life. No cure is available and the therapy typically prescribed has the potential for significant toxicity (2). OA is also estimated to cost $86 billion annually (3). In addition to prevalence and cost, concerns about the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDS) have led many patients with OA to look for complementary modalities to relieve symptoms and improve function with lower cost and fewer side effects (4).

Age-standardised disability-adjusted life year (DALY) rates from Osteoarthritis by country (per 100,000 inhabitants). Data from Death and DALY estimates for 2004 by cause for WHO Member States (Persons, all ages). Combined by Lokal_Profil

OA is a disease often seen in older individuals. More than 80% of people over age 75 have clinical OA, and more than 80% over age 50 have radiologic evidence of OA (5). OA is primarily a disease of the cartilage that progressively produces a local response in the tissue, a mechanical change in the articulation of the joint, and failure of function. OA is associated with inflammation and can result from excessive or repetitive motion of the normal joint. Cartilage in the joint is damaged becoming thinner as it develops fissures or large clefts, and proteoglycan synthesis decreases (2). The inflammatory process and joint damage leads to further decrease in load-bearing capacity leading to further destructive processes in the joint. Joints commonly involved in OA are the fingers, hips, knees, and spine. This study focused on the knee because of the higher prevalence of symptomatic knee OA (6, 7), and the authors considered knee joints more accessible for clinical exam and quantitative measures of treatment response.

Therapeutic Touch (TT), developed by Kreiger and Kunz (8), is a complementary modality recognized by the National Institutes of Health and categorized as a manual healing method (9). TT is supported by Rogers’ holistic nursing theory (10, 11) which states that all persons are highly complex fields of various forms of life energy. The system is open so the fields of energy are in constant interaction and exchange with surrounding energy fields thereby changing each other. In TT, the practitioner moves energy through his or her hands to the patient thus restoring balance and increasing the person’s capacity to heal (12-15). TT facilitates pattern change and, when dealing with people with chronic pain, time is needed to “overcome” the person’s long held belief that change is not possible (16). Therefore, a number of treatments over time are necessary to be effective in restoring balance and changing patterns of chronic pain thus decreasing perception of pain and improving function. Treatment in this study was standardized applying the standard Kreiger-Kunz method as established by Nurse Healers-Professional Associates International (17).

The use of TT for related pain syndromes such as fibromyalgia (18, 19) and orthopedic conditions (20) is growing. Several studies support the use of TT as an intervention for the suffering associated with OA. In a previous study, Gordon and colleagues (21) examined the results of 4 weeks of TT on patients diagnosed with OA of the knee. Twenty-five patients were randomly given TT, mock therapeutic touch (MTT), or neither. The TT group improved significantly more than MTT and standard treatment groups on scores for pain severity, outdoor work, general activity level, interference, affective distress, punishing response, and life control (21). The study was conducted with a small group of subjects. The promising results indicated that the treatment group had significantly decreased pain and improved function compared with the placebo and control groups. The results of the Gordon study are encouraging; however, further research is needed. Therefore, the current study doubled the number of treatments by administering two treatments a week as compared to one. The researchers extended the treatment period to eight weeks instead of four and included a larger sample size.

Another study conducted by Peck (22) explored the use of TT compared with progressive muscle relaxation (PMR) to decrease pain of OA in elders. Both groups experienced significant decreases in pain and distress. Hand function improved after TT while walking, and bending improved after PMR. Functional ability was significantly different between the two groups for mobility and hand function with better function attained by the TT group.

The purpose of the current study was to determine the effect of twice weekly therapeutic touch treatments on pain, level of functioning, and quality of life (general well-being and mood) over the course of eight weeks. The current study tested the hypotheses that a treatment protocol of TT would: 1) decrease pain scores, 2) improve quality of life, and 3) improve level of function in persons with OA of the knee.

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