Touch therapies for pain relief in adults.
BACKGROUND
Pain is a global public health problem affecting the lives of large numbers of patients and their families. Touch therapies (Healing Touch (HT), Therapeutic Touch (TT) and Reiki) have been found to relieve pain, but some reviews have suggested there is insufficient evidence to support their use.


OBJECTIVE
To evaluate the effectiveness of touch therapies (including HT, TT, and Reiki) on relieving both acute and chronic pain; to determine any adverse effect of touch therapies.


METHODS
Various electronic databases, including The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED and others from their inception to June 2008 were searched. Reference lists and bibliographies of relevant articles and organizations were checked. Experts in touch therapies were contacted.


METHODS
Randomized Controlled Trials (RCTs) or Controlled Clinical Trials (CCTs) evaluating the effect of touch on any type of pain were included. Similarly, only studies using a sham placebo or a 'no treatment' control was included.


METHODS
Data was extracted and quality assessment was conducted by two independent review authors. The mean pain intensity for completing all treatment sessions was extracted. Pain intensity from different pain measurement scales were standardized into a single scale. Comparisons between the effects of treatment groups and that of control groups were made.


RESULTS
Twenty four studies involving 1153 participants met the inclusion criteria. There were five, sixteen and three studies on HT, TT and Reiki respectively. Participants exposed to touch had on average of 0.83 units (on a 0 to ten scale) lower pain intensity than unexposed participants (95% Confidence Interval: -1.16 to -0.50). Results of trials conducted by more experienced practitioners appeared to yield greater effects in pain reduction. It is also apparent that these trials yielding greater effects were from the Reiki studies. Whether more experienced practitioners or certain types of touch therapy brought better pain reduction should be further investigated. Two of the five studies evaluating analgesic usage supported the claim that touch therapies minimized analgesic usage. The placebo effect was also explored. No statistically significant (P = 0.29) placebo effect was identified.


CONCLUSIONS
Touch therapies may have a modest effect in pain relief. More studies on HT and Reiki in relieving pain are needed. More studies including children are also required to evaluate the effect of touch on children.
So
Pui Shan
PS
Surgery, Prince of Wales Hospital, Ward 3D, Prince of Wales Hospital, Ngan Shing Street Shatin, Hong Kong, Hong Kong, China, HKSAR. Sophiaso@gmail.com
Jiang
Yu
Y
Qin
Ying
Y
D000328:Adult; D006801:Humans; D059408:Pain Management; D016032:Randomized Controlled Trials as Topic; D019124:Therapeutic Touch / Q000379:methods*