Improving Chronic Pain Outcomes with Integrative Nursing Interventions

Purpose: Pain is one of the leading causes that individuals seek healthcare, however, clinical outcomes for patients with pain are not ideal. The purpose of this presentation is to describe integrative approaches for pain management, examine the results of a clinical trial that evaluated a non-invasive neuroelectrical stimulation therapy for patients with chronic pain and discuss the delivery of integrative nursing interventions for pain management.

 Methods: A double-blinded randomized sham-controlled trial was conducted to evaluate a non-invasive neurocutaneous electrical stimulation therapy for patients with chronic pain. Subjective pain ratings, pain sensitivity measured by quantitative sensory testing, and mRNA expression profiles of pain sensitivity genes were assessed in participants before and after the intervention. Clinical outcome measures included functional abilities (physical function, exercise, work), symptom self-management and quality of life.

Results: Compared with the sham group, the Calmare group showed a significant decrease in the “worst” pain and interference scores at three weeks follow-up. There were also significant differences in measures of pain sensitivity and differential mRNA expression of 17 pain genes between the Calmare and sham groups suggesting that Calmare can be effective in reducing pain intensity and interference in individuals with persistent low back pain by altering the mechanisms of enhanced pain sensitivity.

Conclusion: Integrative approaches that incorporate multi-modal strategies for pain management can improve clinical outcomes for patients with chronic pain. Nurses can use this research to inform the delivery of integrative interventions for patients suffering with chronic pain.