Systematic Review of Relaxation Interventions for Pain

PURPOSE: To review randomized trials of relaxation interventions used for the treatment of pain in adults and to synthesize evidence regarding the efficacy of specific techniques. DESIGN: Integrative review. METHODS: A literature search was conducted using the terms "relaxation" and "pain" in CINAHL, Medline, and PsychInfo from 1996 to March 2005. Studies were reviewed and categorized based on the type of relaxation intervention (progressive muscle relaxation [PMR], autogenic training, jaw relaxation, rhythmic breathing, and other relaxation exercises), and summarized with respect to various study characteristics and results. FINDINGS: Researchers reported support for relaxation interventions in 8 of the 15 studies reviewed. The most frequently supported technique was progressive muscle relaxation, particularly for arthritis pain. Investigators reported support for jaw relaxation and a systematic relaxation intervention for relieving postoperative pain. Little evidence was found for autogenic training, and no support for rhythmic breathing or other relaxation techniques. CONCLUSIONS: Most of the studies reviewed had weaknesses in methodology, which limited the ability to draw conclusions about interventions. Further research is needed to confirm positive findings related to PMR, jaw relaxation, and systematic relaxation, to address questions related to the dose-response relationship and the individual differences that might influence response to relaxation interventions. These and other relaxation techniques require testing in carefully designed and conducted trials.