Nc Abbot

Spiritual healing as a therapy for chronic pain : a randomized, clinical trial

&NA; Spiritual healing is a popular complementary and alternative therapy; in the UK almost 13 000 members are registered in nine separate healing organisations. The present randomized clinical trial was designed to investigate the efficacy of healing in the treatment of chronic pain. One hundred and twenty patients suffering from chronic pain, predominantly of neuropathic and nociceptive origin resistant to conventional treatments, were recruited from a Pain Management Clinic. The trial had two parts: face‐to‐face healing or simulated face‐to‐face healing for 30 min per week for 8 weeks (part I); and distant healing or no healing for 30 min per week for 8 weeks (part II). The McGill Pain Questionnaire was pre‐defined as the primary outcome measure, and sample size was calculated to detect a difference of 8 units on the total pain rating index of this instrument after 8 weeks of healing. VASs for pain, SF36, HAD scale, MYMOP and patient subjective experiences at week 8 were employed as secondary outcome measures. Data from all patients who reached the pre‐defined mid‐point of 4 weeks (50 subjects in part I and 55 subjects in part II) were included in the analysis. Two baseline measurements of outcome measures were made, 3 weeks apart, and no significant differences were observed between them. After eight sessions there were significant decreases from baseline in McGill Pain Questionnaire total pain rating index score for both groups in part I and for the control group in part II. However, there were no statistically significant differences between healing and control groups in either part. In part I the primary outcome measure decreased from 32.8 (95% CI 28.5–37.0) to 23.3 (16.8–29.7) in the healing group and from 33.1 (27.2–38.9) to 26.1 (19.3–32.9) in the simulated healing group. In part II it changed from 29.6 (24.8–34.4) to 24.0 (18.7–29.4) in the distant healing group and from 31.0 (25.8–36.2) to 21.0 (15.7–26.2) in the no healing group. Subjects in healing groups in both parts I and II reported significantly more ‘unusual experiences’ during the sessions, but the clinical relevance of this is unclear. It was concluded that a specific effect of face‐to‐face or distant healing on chronic pain could not be demonstrated over eight treatment sessions in these patients.

Sympathetic vasomotor dysfunction in leprosy patients: comparison with electrophysiological measurement and qualitative sensation testing

Testing of skin vasomotor reflexes (VRs) by laser Doppler flowmetry (LDF) is now a recognised method of measuring peripheral dysautonomia. To assess its specificity as an indicator of impairment to unmyelinated autonomic fibres, VR testing at the fingerpulp was compared with standard qualitative sensation (QST) and with sensory electrophysiological (SNVC) measurements in 39 Iranian leprosy patients. There was a significant relationship between VR and SNCV values (but not QST): these were jointly measurable in 38.5% of fingers, and jointly absent in 35.3% of fingers which also showed significantly reduced LDF perfusion and skin temperatures. However, in 10.3% of fingers, predominantly index and otherwise apparently healthy, VRs were absent but SNCV present, suggesting early sub-clinical autonomic impairment. In a further 16% of fingers, predominantly ulnar and with poor microcirculation, intact (though impaired) VRs could be recorded despite the absence of SNCV responses, suggesting sparing or regeneration of these fibres. This evidence suggests that where there is heterogeneity of nerve damage a combination of VR and electrophysiological testing can indicate the functional status of distinct fibre types.

Spirituele healing als therapie voor chronische pijn: een willekeurige, klinische test

Spiritual healing as a therapy for chronic pain: a randomized, clinical trial [Pain 2001;91:79-89]

Spiritual healing as a therapy for chronic pain: a randomized, clinical trial (Abbot et al., PAIN 2001;91:79–89)

know, because the study was not powered to detect an effect of that magnitude. However, in patients with chronic pain even small effects are sizeable and worth the effort. The authors have not shown a specific effect of the size anticipated. But it was unreasonable in the first place, we contend, to anticipate a specific effect of d 1⁄4 0:8. They have shown strong non-specific effects, and we hold that also these are therapeutically valuable with chronic pain patients. And they have found a small but rather interesting specific effect. Alas, the study was not powered to detect it. The question is still open, whether spiritual healing has a specific effect. What is increasingly emerging is the fact that the non-specific effects are sizeable. We are wondering whether it is not time for the scientific community to pose the question, how these non-specific effects are produced and how they can be harnessed for effective treatment. Healing seems to be one method to do this.