Non-Narcotic Therapies for Pain Management

1. Non-Narcotic Therapies for Pain Management Nanette Brown Karen Bowers Laura Parker Kathy Vietti

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

3. The Questions • What alternative /non narcotic treatments for pain are available? • What are the most effective complementary alternative medicine s (CAMs) for pain control?

4. 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)

5. Treatment Caveats • Thorough pain assessment/history. • Restoration of functionality to an acceptable level (McCarberg, 2007) • Individualized

6. 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)

7. 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)

8. 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)

9. 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)

10. 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)

11. 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)

12. Massage Therapy • Most popular complementary therapy • Human touch • Pain relief and relaxation

13. Massage Therapy • Reduces anxiety & stress • Improves sleep and emotional well being • Lowers blood pressure • Reduces pain • Promotes healing process

14. 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

15. 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

16. 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

17. 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

18. 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

19. Conclusion • Limited nursing research available • Identified multiple topics for future nursing studies • Opportunities for nurse practitioners to incorporate these therapies

20. 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

21. 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

22. 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