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  1. Spirituality and Religion in Pain and Pain Management
  2. Spirituality and Religion in Pain and Pain Management
  3. Background

Biomedical and Spiritual Approaches. Help your clients achieve victory over chronic pain and lead more fulfilling lives! Incorporating biomedical, surgical, psychological, social, and spiritual perspectives, it provides vital, up-to-date information about how to reduce physical pain and explores techniques for improving people's ability to cope with it.

Helpful tables provide easy access to information on medications for pain and managing side effects. Biomedical and Spiritual Approaches is filled with resources for the person in pain and for the health or religious professionals working to help them. It gives you very specific suggestions on how to manage chronic pain, including detailed information about medications, alternative therapies, psychological treatments, and spiritual strategies for pain management. The book is completed by two thoughtful appendixes: Health professionals who provide care to patients with chronic pain are the most important agents for pain management.

Therefore, health professionals should be attuned to the biological, psychosocial needs of their patients in their efforts to holistically address pain. Pain management may entail various behavioral, religious, medication prescription and alternative , and surgical options. One of the medical care goals is to explore the psychosocial factors involved in the pain experience and attempt to address misconceptions, modify or change unhelpful coping strategies and enforce positive ones. More recently, spirituality as a concept has been included into the BPSM.

As the biopsychosocial- spiritual model BPSSM suggests illness disrupts the biological, interpersonal, and spiritual relationships unique to the individual. The BPSSM recognizes the potential impact of spiritual and religious variables that may increase or decrease experience of illness and pain responsiveness.

God is abandoning me is related to increased pain sensitivity. Spirituality and religion may influence the experience of pain and fatigue. Religious people are less likely to have pain and fatigue according to Baetz and Bowen. They obtained data from They also found that those with chronic pain and fatigue were more likely to use prayer and seek spiritual support as a coping method compared to other people.

Pain sufferers who were both religious and spiritual were more likely to have beter psychological well being and use positive strategies. Spiritual interventions vary according to the culture. Pray is a universal spiritual practice; it may take the form of intercessory prayer, confession, gratitude, or silent communion. Prayer involves no direct physical contact and no attempt to do anything or give anything. The only goal is to become a loved one for his or her God. Seeking medical care and using prayer are not mutually exclusive activities.

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God is responsible for health, and spiritual beliefs are most effective way to influence healing. Patients with pain may practice a number of religious and spiritual interventions, such as prayer, seeking spiritual support, to cope with their pain. This has been characterized as either external powerful sources of disease control and on internal powers and virtues. Intrinsic religion and reapprasial were valued moderately, while spiritual quest orientation was of minor relevance. Correlational research has suggested that individuals with strong religious and spiritual lives tend to be healthier, psychologically and physically.

In a meta-analysis of independent studies of religiousness and depressive symptoms, religiousness appeared to protect aganist depression, particularly in times of major life stress. This relationship also held true in a study of chronic pain patients; those who reported more spiritual experiences also reported more positive mental health. Furthermore, the relationship between spirituality and mental health was strongest among those reporting higher levels of pain. Beliefs about the nature of God run the gamut between a loving and a punishing God.

Future research should include not only the presence or absence of a belief in a higher power, but also the type of beliefs the participant holds about God, since the valence of belief can affect mental and physical health outcomes. Negative meaning making appears to diminish resilience leading to poorer coping abilities. Prayer, when used as a means to relinquish control and responsibility for pain solutions, can negatively impact disability and perceived self control.

It may be that the moderate use of religion and spirituality resources are a more effective tool for treating pain when the individual stil retains some form of self efficacy and responsibility, but also feels supported by their higher power. Balance is needed between self efficacy and the relinquishment of control to an outside party, whether that outside force is religious and spiritual or medical and pharmacological.

When people cannot find relief from the medical profession for intense and debilitating pain they are likely to turn to an alternative source for help in coping. Fifty-eight per cent of patients were grounded on religion or spirituality and give meaning but not in the context of religion or spirituality. Open mindedness may also be a predictor of well being.

In the study by Dezutter et al. Symbolic inclusion individuals are more open minded and assume that several interpretations of religious content is possible, and Symbolic Exclusion individuals are less judgmental toward religiosity but do not think they need religiosity to find meaning for their life. Higher levels of wellbeing in the chronic pain sample were significantly related to Symbolic Inclusion and Symbolic Exclusion and lower levels of wellbeing were significantly related to Literal Exclusion, suggesting that a more open minded attitude toward religion and what lies beyond the ordinary might buffer the effects of chronic pain by offering meaning making, purpose, and hope.

Chronic pain may cause people to turn to the practices that religious and spiritual institutions advocate for better psychological, mental, and even physical health. Spirituality-based strategies are commonly used to cope with chronic pain. Chronic pain patients with a variety of conditions e. These participants reported using positive religious and spiritual coping strategies much more frequently than negative religious and spiritual coping strategies. This finding lend support to the possibility that coping with chronically painful medical condition may sensitize one or even enhance spiritual or religious connectedness.

Chronic Illness Impact and Intervention Lubkin, Chronic Illness

Whether positive or negative, religious and spiritual coping strategies thus seem to influence suffering from experienced pain. Positive coping includes collaborative problem solving with God, helping others indeed, and seeking spiritual support from the community and from a higher power. Negative coping includes deferring all responsibility to God, feeling abandoned by God, and blaming God for difficulies. Negative coping appeared to be more adaptive and those who felt they were punished by God saw the pain as retribution from God, and the other negative copiers made patients feel abandoned by God during the time when they most needed support.

Many religious and spiritual practices are intended to help the practitioner to experience feelings of spiritual support. A study by Wiech et al. Twelve practicing Catholics and twelve non-religious, non-spiritual individuals participated. They were shown two pictures of women in a similar pose, the Virgin Mary and an unknown woman, while they received a repetitive noxious electrical stimulation. Both groups were equally sensitive to the pain but the religious group reported less pain when looking at the picture of the Virgin Mary while the non-religious group reported the same amount of pain.

The non-religious group preferred the picture of the other woman although the picture did not lessen their pain. The Catholic participants reported that they were in a calm, meditative state when the religious image was presented to them. These researchers found that the right ventrolateral prefrontal cortex VLPFC cluster in the brain was specifically activated in the religious sample when looking at the Virgin Mary, but not in the nonreligious sample. The VLPFC is also involved in other cognitive processes which is long-term memory and working memory maintenance.

Post scan reports suggested that the Catholic sample used a strategy known as self-focused reappraisal that allowed them to down regulate the perceived intensity of the pain when presented with a religious image. The image of the Virgin Maryis felt to Catholics projects a calming presence of understanding and support that allows these individuals to feel supported by their higher power. Meaning making symbols can thus influence the experience of pain.

This study also evaluated whether different forms of religious coping were associated with different outcomes. The researchres gathered information from 61 patients seeking treatment at a pain management center. Most of patient were Caucasian women with fibromyalgia, arthritis, post surgical, and carpal tunel pain. Patients provided a wide array of demographic data, 51 percent indicated that they were moderately religious and 30 percent reported that they were very religious.

The participants also completed questionnaires concerning how pain, affected their lives, how they coped with the pain, the role and functional of religious faith and practice in their lives, their general mood, and outcomes related to their coping process. As regards the first question, religious and nonreligious coping were moderately related to pain outcomes after accounting for the influence of demographic variables. More specifically, the positive religious coping items were correlated with increased positive affects and a strengthening of religious faith and practice.

Religious coping efforts were more helpful than nonreligious coping. Giving attention to these religious processes may improve treatment outcomes. Researchers suggested that elderly individuals report using a repertoire of pharmacologic and nonpharmacologic strategies to manage chronic pain. Older women and elderly individuals of minority racial background reported using religious coping strategies to manage their pain more often than did older Caucasian men.

Older women also reported using diversion and exercise significantly more often than did older men. A study by Wachholtz and Pargament randomly assigned 84 college students to one of three groups, relaxation, secular meditation, and spiritual meditation. Participants filled out psychological and spiritual assessments prior to learning their technique.

Spirituality and Religion in Pain and Pain Management

After practicing their technique for 20 minutes a day for two weeks, each individual placed their hand up to their wrist in a cold water bath and held it there for as long as they could. Psychological and spiritual assessments were completed again. The spiritual meditation group reported significantly more mystical experiences than the other two groups and a greater increase in closeness to God.

Furthermore, although they reported the same subjective level of pain as the other groups they were able to endure the pain level almost twice as long as the other two groups. There is some debate regarding the role of spirituality and the impact of meditation on health. They were assessed through a pretest on headache frequency and severity, affect, anxiety, depression, quality of life, self efficacy, religious demographics, spiritual well-being, and spiritual experiences.

Following one month of 20 minutes a day practice, the participants returned to the lab to practice their technique followed by placing their hand in a cold pressor bath. Next they completed a follow-up assessment. The Spiritual Meditation group reported a significantly greater reduction in headaches and greater pain tolerance in comparison to the other groups as well as an increase in existential well-being.

God is peace, God is joy, God is good , or God is love. All four phrases express a sense of goodness, support and comfort similar to what the participants in the Wiech et al. Repeating these phrases, or using visual stimuli can make these spiritual resources more salient to individuals who are experiencing pain. Spiritual coping is discussed in many studies, so far. Finally, both positive and negative spirituality and religious practices were strongly related to well-being for the clergy. In some of studies, reported cultural differences are affect the results that related to both negative and positive spiritual and religious coping.

In these studies shown that, in different cultural settings are also affected spiritual and religious coping during times of stres and illness. Also, there are some Jews, Christian, and others. In Turkish sources, little empirical research has explored the specific ways in which religious and spiritual coping may directly impact chronic pain. However, numerous studies demonstrated that there is a negative relationship between spiritually and symptoms related chronic disease e.

There is a positive relationship between spirituality and well-being, life satisfaction and the quality of life. Studies conducted in Turkey are given below. These studies are related to spirituality, pain and chronic illness. A study by Ozer examined perception and definition of the quality of life in patients with heart failure.

The research participants reported prayer is one of the most important things to improve the quality of life. These participants reported, they pray for coping with a high level of pain distress, and pray that their pain should not start again. When their pain starts they squeeze their fists and clench their theeth in order to endure the severity of pain.

Spirituality and Religion in Pain and Pain Management

A study by Afsar and Pinar evaluated spirituality in cancer patients with various types of advanced cancer and found that spiritual activities influenced their general happiness and life satisfaction. Cancer patients also reported, when they experienced pain they preferred social isolation, a change in their enviroment, massage and lying down or resting as coping strategies. The spouse reported experiencing hopelessness, spiritual distress and failure in coping with social problems. Karakavak and Cirak interviewed mothers with children having chronical diseases, about their feelings, adjustment, support systems during the care of their child.

They were found to have used some strategies to cope with their children illness including religious belief, praying, receiving social support to their families and consulting to health professionals. Mothers try to cope with the illness of their children by the help of spiritual feelings and live their spirituality through religious beliefs and practices to pray, reciting the Koran, to perform namaze etc. Mothers attempted to perform religious practices visiting shrines, having amulets, consulting to a hodja, to recite Koran, use herbal teas etc.

These studies also found some adverse effects of religious and spiritual interventions as strategies to cope with chronic illnesses and their symptoms pain, depression, anxiety, hopelessness, fatigue, distres. Several spirituality interventions have been applied in nursing practice, such as prayer, use of honey.

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  4. There are several spirituality interventions that should be researched and applied in holistic care. Spirituality interventions is very effective for individuals health, illness, and in recovering from diseases. Regarding all these individual and social variations, health professional can choose the proper way to care for patients in the light of their belief systems and religious values. The most important role of the health professionals are to help their patients in the most appropriate and effective way. Health professionals need to be more aware of the importance of spirituality and religion in helping and supporting people having pain.

    Once health professionals learn from patients about their spiritual or religious nature that might be crucial for their personal health care, they should, just as for any physical or psychosocial symptom, develop a pain treatment plan that reflects appropriate goals of care. Currently, studies suggest that few clinicians incorporate discussions about spirituality into their care of patients, while conversely many patients want spirituality to be considered within their health care options.

    Spiritual history should be taken as part of a holistic patient care. Health professionals need to be more aware of the importance of spirituality and religion in helping and supporting people in pain.


    In conclusion, this literature review highlights the importance of spirituality and religion as strategies for coping with pain. People with chronic pain turn to their religion and spirituality to cope with their condition. Religious or spiritual practices can help in managing pain in several ways. Although both religious and spiritual beliefs influence pain management, sometimes people believe that opioid substances or intravenous medication is forbidden in their religious belief and might reject medical or surgical pain interventions.

    Therefore, further research is needed to integrate spirituality and religion into clinical pain management. National Center for Biotechnology Information , U. Journal List Health Psychol Res v. Published online Sep Ozden Dedeli 1 and Gulten Kaptan 2. Author information Article notes Copyright and License information Disclaimer. Received Mar 9; Accepted Jun 2. This article has been cited by other articles in PMC. Abstract Pain relief is a management problem for many patients, their families, and the medical professionals caring for them.

    Background Studies concerning pain can be traced back as early as Babylonian clay tablets. Spirituality, religion and pain Pain is a complex phenomenon involving a cascade of behavioral responses, thoughts, and emotions. Spiritual interventions based on pain management Spirituality-based strategies are commonly used to cope with chronic pain. Discussion Several spirituality interventions have been applied in nursing practice, such as prayer, use of honey. Conclusions In conclusion, this literature review highlights the importance of spirituality and religion as strategies for coping with pain.