Integration of Behavioral and Relaxation Approaches Into the Treatment of Chronic Pain and Insomnia
by the National Institute of Health Technology Assessment Panel
Appearing in the Journal of the American Medical Association
Objectives: To provide physicians with a responsible assessment of the integration of behavioral and relaxation approaches in the treatment of chronic pain and insomnia.
Conclusions: A number of well-defined behavioral and relaxation interventions now exist and are effective in the treatment of chronic pain and insomnia. The panel found strong evidence for the use of relaxation techniques in reducing chronic pain in a variety of medical conditions as well as strong evidence for the use of hypnosis in alleviating pain associated with cancer. The evidence was moderate for the effectiveness of cognitive-behavioral techniques and biofeedback in relieving chronic pain. Regarding insomnia, behavioral techniques, particularly relaxation and biofeedback, produce improvements in some aspects of sleep, but it is questionable whether the magnitude of the improvement in sleep onset and total sleep time are clinically significant.