EMDR in the treatment of chronic pain Research summary

EMDR in the treatment of chronic pain
Research summary

Mark Grant, February 2018



1992;              The first published report of EMDR in the treatment (McCann 1993)
1992-2018      13  Observational studies
3 x Randomized Controlled Trials
3 x research reviews


Research reviews:

1.     Van Rood, deroos (2009)
Conclusion: Recommended investigation of EMDR given role of trauma in pain and prevalence of somatization disorders.

2.     Gerhardt, Eich et al (2013)
Concluded; “early evidence for usefulness of EMDR in chronic pain conditions”

3.     Tesarz, Leisner et al, (2014}
Concluded; “promising results reported for PLP, headache and chronic musculoskeletal pain (High effect sizes noted).

Outcomes

The strongest evidence for EMDR in the treatment of chronic pain pertains to the treatment of PLP, headaches and chronic musculoskeletal pain. The evidence for other types of pain (eg; Fibromyalgia, CRPS) is less strong.

Tesarz & Leiisner et al also noted that; “The effects of EMDR are mainly associated with decreased pain intensity and emotional distress and that results tended to be maintained or showed even further improvement upon at follow-up.

Summary
There are a multitude of studies regarding EMDR treatment of pain comprising over 13 observational studies and 3 RCT’s. Studies tend to show reductions in pain and emotional distress (including PTSD symptoms) with gains generally well-maintained. With the possible exception of the pilot RCT study by Gerhardt (2016) a good RCT is lacking. In this sense research evidence for EMDR treatment of pain has not kept up with that involving EMDR treatment of PTSD.  In terms of the current status of EMDR as an evidence-based treatment for chronic pain, based on National Health and Medical Research Council criteria (see appendix a) EMDR can be considered a level 3 – 4 (where level 1 is gold standard). The evidence is thus promising but more well-designed RCT’s are needed.

References

de Roos CJAM, Veenstra, AC, den Holllander-Gijsman, ME, van der Wee, NJA, de Jongh, A, Zitman, FG, van Rood, RY. (2006) Eye Movement Desensitization and Reprocessing (EMDR) for Chronic Phantom


C de Roos, MA, AC Veenstra, MA, Prof A de Jongh, PhD, ME den Hollander-Gijsman, MA, NJA van der Wee, PhD, Prof FG Zitman, PhD, and YR van Rood, PhD (2010) Treatment of chronic phantom limb pain using a trauma-focused psychological approach Pain Res Manag. 2010 Mar-Apr; 15(2): 65–71.

Eye Movement Desensitization and Reprocessing vs. Treatment-as-Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study. Front Psychiatry. 2016 Dec 20;7:201. doi: 10.3389/fpsyt.2016.00201. eCollection 2016.

Grant, M (2000) EMDR: a new treatment for trauma and chronic pain. Complimentary Therapies in Nursing & Midwifery, 6, 91-94 Harcourt.

Grant, M. & Threlfo, C. (2002). EMDR in the treatment of chronic pain.
 Journal of Clinical Psychology, 58(12), 1505-1520.

Grant M. (2014)  Eye Movement Desensitization Reprocessing treatment of chronic pain. OA Musculoskeletal Medicine Aug. 17(2), 17.

Mazzola, Alexandra, Calcagno, Marea, Lujon, Goicochea, et al., (2009) EMDR in the treatment of Chronic Pain. (2009)  Journal of EMDR Practice and Research. 3(2) 66-79. 

McCann, David. (1993). Post-traumatic stress disorder due to devastating burns overcome by single session eye movement desensitization. Journal of behavior therapy and experimental psychiatry. 23. 319-23. 10.1016/0005-7916(92)90055-N.

Ray, Albert R., & Zbik, Albert (2002). Cognitive Behavioral Therapies and Beyond. In; Tollison, C.David Sattherwaite, John R., & Tollison, Joseph W., (Eds). Practical Pain Management. P 189 – 207. Philadelphia, Lippincott Williams & Wilkins

Schneider, Jens, Hofman, Arne, Rost, Christine, Shapiro, Francine. (2007) EMDR in the Treatment of Chronic Phantom Limb Pain. Journal of EMDR Practice and Research. 1(1) 31-45.

Tesarz J, Leisner S, Gerhardt A, Janke S, Seidler GH, Eich W, Hartmann M. (2014)  Effects of Eye Movement Desensitization and Reprocessing Treatment on chronic pain patients: A systematic Review. Pain Medicine. Feb;15(2):247-63.


Appendix a

Australian NHMRC criteria for evidence-based treatments

       Level 1
            Systematic review of all RCT’s

       Level 2

            At least one properly designed RCT
           
       Level 3
            Well designed pseudo-randomized RCT’s

       Level 4
            Case-series (pre-test and post-test)


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