Using Guided Imagery to Reduce Pain and Anxiety

Background:  The Institute of Medicine in 2011 reported over 100 million American adults are affected by chronic pain which is more than the combination of those affected with heart disease, cancer, and diabetes.  Also the United States is estimated spends up to $635 billion annually in medical treatment and lost productivity due to chronic pain.   The 2007 National Health Interview Survey reported 38% of American adults use some form of integrative or complementary and alternative medicine (CAM).  The National Center for Complementary and Alternative Medicine estimates CAM use accounts for $33.9 billion total health care expenditures spent out of pocket. Conditions associated with pain are the number one reason adults reported as the reason for using CAM therapies.  Research on guided imagery has produced mixed results in its use in pain management.

Purpose:  The study examined the impact of guided imagery on pain and anxiety in adult patients at a tertiary care hospital located in the Texas Medical Center in Houston, TX.

Materials & Methods:  After Institutional Review Board approval, patients were recruited from an advanced practice nurse (APN)-led pain management service.  Consented patients received an MP3 player with a guided imagery recording along with instructions to use the recording twice daily.  Pain and anxiety scores along with analgesic and anti-anxiolytic use were recorded pre-intervention and 24 and 48 hours after enrollment.

Results:  Thirty six patients were enrolled. 

• Pain scores declined by 6 % (48 hour) pain score from pre-intervention score. 
• 28% (24 hours) and 50% (48 hours) decline in anxiety scores when compared to pre-intervention. 
• Analgesia use declined 16% (24 hours) and 19% (48 hours).
• Positive feedback was received from the participants.

Conclusions: 

• Statistical significance was seen with anxiety scores at 24 hours (p = 0.0001) and 48 hours (p < 0.0001) but not with the other measures due to small sample size.
• Clinical significance was seen with declines at 48 hours in anxiety scores (50%), analgesia use (19%), and pain scores (6%).
• Guided imagery appears to be a viable CAM approach to reduce pain, anxiety, and analgesic use.