Many dismiss Complementary and Alternative Medicines such as Therapeutic Touch due to a lack of physiological data accrued from trials (NCCAM, 2000). Therapeutic Touch is considered by those in the field to provide multidimensional effects, not only physiologically, but in thought, feeling, and also spiritually (Leskowitz, 2011). Conventional Controlled Clinical Trials and Randomised Controlled Trials do not consider these additional dimensions, and consequently the results from Therapeutic Touch trials may be severely limited (Fonnebo et al, 2007).
If, however, trials conducted on a multidimensional level were to be considered, the evidence collated would suggest that Therapeutic Touch does reduce pain. Further research into trial methodologies may be required to further support this evidence.
Within the approach of Complementary and Alternative Medicine, Therapeutic Touch falls into the domain of energy or biofield therapies. Therapeutic Touch is a technique by which a practitioner’s hands are used to rebalance the energy field of a patient with the objective of encouraging healing (NCCAM, 2000). Widely practised by many professionals in the health care sector including nurses, occupational therapists, and physical therapists, Therapeutic Touch has been used to induce relaxation, as well as to reduce stress, anxiety, and pain (Winstead-Fry & Good, 2009). Conditions and illnesses in which Therapeutic Touch has been used to promote the previous outcomes include: Fibromyalgia Syndrome (Dennison, 2004); chronic pain (Marta et al (2010), Lin (1998); arthritis (Peck (1998), Gordon et al (1998)); cancer (Giasson & Bouchard (1998), Aghabati et al (2010), Kelly et al (2004)); Carpal Tunnel Syndrome (Blankfield et al, 2001); post surgical pain (Frank et al (2007), McCormack (2009)). The success of these applications with regard to pain will be looked at in detail below.
Therapeutic Touch and Pain
Complementary and Alternative Medicine, of which Therapeutic Touch is included, is widely dismissed, due to its subjective nature and unconventionally scientific foundations (NCCAM, 2000). Trials such as those by Frank et al (2007) and Blankfield et al (2001) provide support for these claims as it was found that there was no measured decrease in pain felt by those participants receiving Therapeutic Touch therapy, and that Therapeutic Touch may be dismissed as placebo.
Contrary to this dismissal, (Fonnebo et al, 2007)argues that the conventional approach to achieving acknowledgement in new areas of medical science through controlled randomised trials, generally using a placebo as a control, is not suitable for generating evidence in this area of medicine. In this instance, practises are often simplified causing limitations in data available for collection and analysis, thus restricting any attainable conclusions.
Further to the case of (Fonnebo et al, 2007), Leskowitz (2011) argues that Complementary and Alternative Medicine not only promote physiological benefits, but can provide additional benefits in the form of emotions, thoughts, and also spiritually, all of which are dismissed in conventional medical trials. If trials incorporating these additional dimensions were, however, to be regarded as clear evidence for the case of Complementary and Alternative Medicine and hence Therapeutic Touch, a significant amount of data may be accrued, as shown below.
The following reputable electronic databases were searched to gather information including: The Cochrane Library, PubMed, JStor, Science Direct, and others. Examples of Randomised Controlled Trials, or Controlled Clinical Trials were used to evaluate the effect of Therapeutic Touch on pain. Further to this, trials using pain measurement tools and methods recognised and used in conventional medicine were similarly taken into consideration: visual analogue scales, numerical rating scales, verbal rating scales, McGill Pain Questionnaire, Brief Pain Inventory (Caraceni et al, 2002).
In 2010, Aghabati et al conducted a trial, consisting of 90 cancer patients, to evaluate the effects of Therapeutic Touch on pain. The results of this trial saw a significant reduction in pain of those participants receiving Therapeutic Touch in comparison to those participants in the control group who received customary care. In an equally sized trial of 90 patients experiencing post-surgical pain, McCormack (2009) found that Therapeutic Touch decreased pain in participants more so than in those not receiving Therapeutic Touch.
Two further trials of similar size also concluded a distinctly greater reduction in pain when compared to those in the control group not receiving Therapeutic Touch (Lin (1998), Turner et al 1998). Similarly, in smaller trials, significant improvements were felt as a result of Therapeutic Touch therapy (Dennison (2004), Marta et al (2010), Gordon et al (1998).
In addition to these trials displaying positive reductions in pain as a result of Therapeutic Touch, it can be argued that trials which consider pain on a broader plain may also be considered when evaluating the effects of Therapeutic Touch; for example trials measuring subjective feelings and thoughts associated with a reduction in pain, such as anxiety, tension, well-being, calmness, relaxation, and mood. Trials by Lafreniere et al (1999), Peck (1998), Giasson & Bouchard (1998), and Kelly et al (2004) using multidimensional measurements concluded that that Therapeutic Touch had a marked improvement in these feelings.
The scientific design and consequential limitations of conventional randomised clinical trials have resulted in the dismissal of Complementary and Alternative Medicine such as Therapeutic Touch as an effective treatment in the reduction of pain. However, if other dimensions (emotional, philosophical, and spiritual) were to be taken in to consideration then much more evidence, as the trials above illustrate, could validate the claim that Therapeutic Touch is effective in reducing pain. Therefore, considering the evidence gathered it is concluded that on a multidimensional level, there is sufficient evidence here to suggest that Therapeutic Touch can reduce pain, and that provision in clinical trials is required to further substantiate, or negate these claims.
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