Table 1.
Overview of randomized controlled trials investigating the treatment effect of relaxation technique interventions on chronic pain.
| Authors | Sample | Intervention | Control group | Outcome measure | Results | Follow up |
|---|---|---|---|---|---|---|
| Nazari et al. (2016) | MS (N = 75) | Relaxation (n = 25) vs. reflexology (n = 25) | Treatment as usual (n = 25) | Pain intensity. | Significantly lower pain intensity in the relaxation and reflexology group compared to control group. | No significant differences between the three groups two months after the intervention. |
| Thorsell et al. (2011) | Chronic Pain (N = 90) | Relaxation (n = 35) vs. ACT (n = 35) | Natural history | Quality of life, Pain acceptance, level of activity, depression, anxiety, pain intensity. | Significantly reduced depression and anxiety symptoms. | Significant lower depression and anxiety after 12 months. |
| Rambod et al. (2014) | Hemodialysis patients (N = 81) | Relaxation (n = 41) | Treatment as usual (n = 40) | Pain intensity, quality of life. | Significantly lower pain intensity and improved quality of life. | No follow-up. |
| Turner (1982) | Chronic low-back pain (N = 36) | Relaxation in group therapy (n = 14) vs. CBT group therapy (n = 13) | Wait-list control (n = 9) | Pain intensity, physical functioning, depression. | Significant improvement on all outcome measures. | Significant reduction in pain intensity after one month. Increased pain rate after 1,5-2 years |
| Stuckey et al., (1986) | Chronic low-back pain (N = 24) | Relaxation (n = 8) vs. EMG-biofeedback (n = 8) | Placebo (n = 8) | Pain intensity, daily functioning. | Significant improvement on all outcome measures. | No follow-up. |
| Shariat et al. (2019) | Chronic low-back pain (N = 72) | Relaxation (19) vs. Exercise (19) vs. Exercise and relaxation (19) | Control group (19) | Pain intensity, range of motion, anxiety, quality of life. | Significant effect on pain intensity and anxiety in all treatment groups. Significant effect on range of motion in Exercise and Exercise and relaxation groups. Significant effect on quality of life in Relaxation and Exercise and Relaxation groups. | Significant effect on pain intensity and anxiety after 12 weeks in all treatment groups. Significant effect on range of motion in Exercise and relaxation group after 12 weeks. Significant effect on quality of life in Relaxation and Exercise and Relaxation groups after 12 weeks. |
| Gustavsson and von Koch (2006) | Chronic neck pain (N = 29) | Relaxation (n = 13) | Treatment as usual (n = 16) | Pain intensity, physical functioning, depression and anxiety. | Significantly reduced pain intensity. | Significant lower pain intensity after 20 weeks. |
| Rokicki et al. (1997) | Chronic tension headache (N = 44) | Combined relaxation and EMG-biofeedback-training (n = 30) | Natural history group (n = 14) | Intensity and frequency of headaches. | Significantly reduced frequency of headaches. | No follow-up. |
| Coppieters et al. (2016) | Chronic WAD (N = 15) and FM (N = 20) | Relaxation | Healthy controls (n = 22) | Pain intensity. | Significantly improved pain-modulation in both groups. | No follow-up. |
| Chen and Francis (2010) | Musclepain and migraine (N = 19) | Relaxation (n = 11) | Wait-list controls (n = 8) | Pain intensity, quality of life, mental health, sleep. | No significant effects. | No follow-up. |
| Lauche et al. (2013) | Chronic neckpain (N = 61) | Massage (n = 30) vs. relaxation (n = 31) | Baseline | Pain intensity, quality of life, mental health. | Significantly reduced pain intensity. | No-follow up |
| Viljanen et al. (2003) | Chronic neck pain (N = 340) | Relaxation (n = 110) vs. dynamic muscle training (n = 111) | Treatment as usual (n = 119) | Pain intensity. | No significant effects. | No significant improvement after 3,6 and 12 months. |
| Söderberg et al. (2011) | Chronic tension headache (N = 90) | Relaxation (n = 30) vs. acupuncture (n = 30) vs. physical training (n = 30) | Healthy controls (n = 88) | Qualitiy of life, sleep. | Significant improvement in quality of life and sleep. | Significant improvement after 3 and 6 months. |
| Hasson et al. (2004) | Long lasting muscle pain (N = 120) | Relaxation (n = 55) vs. massage (n = 62) | Baseline | Muscle pain, self-reported health, mental energy. | No significant effects. | No significant improvement after three months. |
| Ter Kuile et al. (1996) | Chronic headache (N = 144) | Self-hypnosis (n = 72) vs. relaxation (n = 72) | Baseline | Pain intensity. | Significantly reduced pain intensity. | Significant improvement after 6 months. |
Note: Biofeedback is a mind-body technique in which patients with chronic pain can modify some of the body functions by receiving information from electrical sensors. EMG (Electromyography) is a biofeedback method that measures and gives feedback about muscle tension. Self-hypnosis is related to relaxation, but relies on changing pain perception rather than eliciting a relaxation response. CBT (cognitive behavioral therapy) aims to change patterns of behavior and thinking. Dynamic muscle training is a type of strength training with light weights (1–3 kg). ACT (Acceptance and commitment therapy) aims to accept thoughts and feelings in the present moment and change behavior in accordance with values. Reflexology is a type of massage with application of specific pressure points on the feet and hands.