How You Can Help Patients with Chronic Pain

  Chronic pain affects millions of people globally and can lead to reduced life quality and disability (Cheung et al., 2016).  If you or your patients suffer from chronic pain, this can lead to a whole host of complications such as depression, insomnia, reduced immunity and increased chances of heart disease. Management of chronic pain utilizes long term use of NSAIDs, sedative medications, surgery, physical therapy or steroid injections, which often provide minimal to no relief. By looking towards integrative, alternative medicine and yoga, we can offer these patients increased comfort (Combs and Thorn, 2015). 

Yoga is one of the most common practice to improve health outcomes present since ancient time. The word yoga means developing a harmonious relationship between body, mind and emotions. It is an exercise based on physical and mental training. One of the main challenges in engaging patients with physical activity is the perception of pain with movement, however, a gentler with less weight-bearing and impact form of yoga that may be appropriate is restorative yoga. This form of yoga uses blocks, props and other accessories to help support patients in passive stretching. Asanas are various physical postures that are held for a specific duration and provide physical as well as psychological benefits. Restorative yoga improves flexibility passively, and reducing contractures (Kanaya et al., 2014) that are commonly seen in those with debility. Other benefits to incorporating a restorative yoga practice with patients is it can help to balance the immune system and nervous system, improves sleep, improves circulation and reduce anxiety levels. Most importantly, it has been shown to reduce pain (Kanaya et al., 2014). However, it is crucial to understand the selection and adaptation of specific Asana for an individual patient (Combs and Thorn, 2015). 

Nurses can integrate restorative yoga in their practice after attaining adequate training about accurate postures, health benefits, breathing practices, and active relaxation. Nurses already have sufficient training about positioning patients with disabilities however, restorative yoga would be an added tool to provide patients with increased comfort, improve range of motion and reduce of pain. Nurses can increase their understanding of contraindications and precautions that must be considered while placing patients in certain positions. In addition, leading patients through a deep breathing practice and meditative practice helps to increase the effectiveness of the asana. Several programs offer license and certification to integrate restorative yoga in nursing practice (Robison, Walter and Godsey, 2019).

With an increase in aging population and diverse health conditions, serious health concerns are being made towards the misuse of pain-relieving medications. Complementary and alternate therapies are attaining more popularity among healthcare practitioners to reduce pain and Yoga is one of the safest therapy. Use of Restorative Yoga is an efficient way to manage chronic pain and disability while receiving other benefits such as improved anxiety, insomnia and more. 

To receive your Certificate in Restorative Yoga, join us for our September session here. For a limited time only, get 10% off with code HEAL2024 off your registration.

References 

Cheung, C., Park, J., & Wyman, J. F. (2016). Effects of yoga on symptoms, physical function, and psychosocial outcomes in adults with osteoarthritis: a focused review. American Journal of Physical Medicine & Rehabilitation, 95(2), 139-151.

Combs, M. A., & Thorn, B. E. (2015). Yoga attitudes in chronic low back pain: Roles of catastrophizing and fear of movement. Complementary therapies in clinical practice, 21(3), 160-165.

Highland, K. B., Schoomaker, A., Rojas, W., Suen, J., Ahmed, A., Zhang, Z., ... & Buckenmaier III, C. C. (2018). Benefits of the restorative exercise and strength training for operational resilience and excellence yoga program for chronic low back pain in service members: a pilot randomized controlled trial. Archives of physical medicine and rehabilitation, 99(1), 91-98.

Kanaya, A. M., Araneta, M. R. G., Pawlowsky, S. B., Barrett-Connor, E., Grady, D., Vittinghoff, E., ... & Tanori, D. (2014). Restorative yoga and metabolic risk factors: The Practicing Restorative Yoga vs. Stretching for the Metabolic Syndrome (PRYSMS) randomized trial. Journal of Diabetes and its Complications, 28(3), 406-412.

Robison, G., Walter, T., & Godsey, J. (2019). Integrating Yoga Therapy into Oncology Care. Oncology Issues, 34(4), 26-35

Using Aromatherapy in Your Holistic Nursing Practice

The use of aromatherapy is on the rise with nurses to promote self-care and promote a therapeutic environment for their patients. Aromatherapy has a long history but its use among nurse professionals has increased steadily in the last few decades. It is has attained much popularity among other complementary therapies. American Nursing Association (ANA) has also recognized Aromatherapy as a legitimate component for holistic nursing (Okpala, 2018).  It is considered as an effective tool to increase nursing care as well as enhance their empowerment. Due to the stressful environment and a high burn out rate among health care professionals, aromatherapy is a helpful tool for promoting the wellbeing of nurses and their patients. (Conrad, 2019). 

Benefits of Aromatherapy

There are several potential benefits of using Aromatherapy in self-care, acute care, palliative and Geriatric care. The use of aromatherapy in community nursing and long-term patient care has also increased. It is effective in reducing anxiety and distress by increasing comfort, relief of pain, relaxation, improved coping, reduction of stress, an increased sense of well-being (Johnson et al., 2016). It is also used to increase ease inpatient experience of disease, treatment and injury.

Some essential oils that have been used frequently are peppermint oil as it can be effective in relieving anxiety, fever, and headache and muscle soreness. Lavender oils are effective to alleviate insomnia as well as treating insect bites. Eucalyptus oil is used in sinus blockage, relieving pain, strains and muscle aches (Okpala, 2018). 

How Aromatherapy is Used

Aromatherapy uses therapeutic graded essential oils either by inhalation (direct or indirect) or via topical use. Inhalation affects the olfactory system, the part of the brain that is directly linked to smell, and its effects are due to it’s interaction with with the limbic system, which is involved in respiration, heart rate and helps to regulate the nervous system. Using essential oils through inhalation has been shown to also stimulate mood, balance the autonomic system and stimulate immune function (Lee at al., 2019). 

Methods of Application of Aromatherapy

There are different ways through which aromatherapy can be applied. Patients are encouraged to directly inhale aroma of essential oils, as this can be the most minimally invasive and have the least effect with medication interactions. Patients can utilize a diffuser, or use 1-2 drops of the essential oil on a cotton ball for several minutes. The scent of the essential oil, 1-2 drop-in a cotton ball or inhaler wick is provided to the patient that they inhale for 5-10 minutes.. It can also be applied in diluted form through spray bottles (Dusek, 2016). The topical application of oil is based on light touch and massaging the oil on a specific area of the body to relieve symptoms of pain. When applying topically, It is recommended that pure essential oils not be directly applied to the skin and diluted with a carrier oil, such as jojoba. More research evidence required to support oral intake of oils (Özkaraman et al., 2018). 

Applying Aromatherapy Into Your Clinical Practice

When integrating aromatherapy into your clinical practice, it is best to engage the patient. As with all therapies, informed consent should be requested from the patient. Certifications are available that help with understanding the pharmacology, mechanism of action and specific therapeutic indications of the essential oils as well as safety. To be most deeply relaxing, aromatherapy can be combined with restorative yoga

In Summary

Aromatherapy is a beneficial form of integrative medicine as it can help to balance the autonomic system, and promote overall well being not only of the patients, but also of the nurse. Because of the diversity of application, aromatherapy is a safe, effective modality and therapy for patients. To incorporate aromatherapy in your practice, certifications are available to understand the therapeutic indications, mechanism of actions of essential oils.

References 

Conrad, P. (2019). Women’s Health Aromatherapy: A Clinically Evidence-Based Guide for Nurses, Midwives, Doulas and Therapists. Singing Dragon.

Dusek, J. A. (2016). Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

Johnson, J. R., Rivard, R. L., Griffin, K. H., Kolste, A. K., Joswiak, D., Kinney, M. E., & Dusek, J. A. (2016). The effectiveness of nurse-delivered aromatherapy in an acute care setting. Complementary therapies in medicine, 25, 164-169.

Lee, S. P., Wu, W. Y., Hsiao, J. K., Zhou, J. H., Chang, H. H., & Chien, C. T. (2019). Aromatherapy: Activating olfactory calcium‐sensing receptors impairs renal hemodynamics via sympathetic nerve‐mediated vasoconstriction. Acta Physiologica, 225(1), e13157.

Okpala, A. (2018). The Use of Aromatherapy in the Reduction of Anxiety Levels (Doctoral dissertation, Brandman University).

Özkaraman, A., Dügüm, Ö., Yılmaz, H. Ö., & Yeşilbalkan, Ö. U. (2018). Aromatherapy. Clinical journal of oncology nursing, 22(2), 203-210.