Eye movement desensitisation and reprocessing in chronic pain conditions

Introduction Chronic pain is prevalent and associated with a high disease burden. However, current treatments for chronic pain provide insufficient relief. Therefore, the exploration of new treatment methods is warranted. Originally, Eye Movement Desensitisation and Reprocessing (EMDR) developed as a treatment approach for post-traumatic symptoms (e.g. post-traumatic stress disorder), and it now shows promising results in the treatment of chronic pain conditions. This paper is a critical review of pertinent articles concerned with the feasibility and usefulness of EMDR in the treatment of chronic pain. Materials and Methods Articles on EMDR were retrieved selectively by searching the literature regularly. This review summarises the findings from EMDR studies conducted for the treatment of chronic pain and also extracts potential theories that may explain the reason why EMDR is a promising treatment for chronic pain conditions. In this review, findings and theories regarding the use of EMDR have been discussed, and the implications for research have been derived. Results Early reports show that EMDR either significantly reduces the intensity of pain or even completely eliminates chronic pain in various pain conditions, including phantom limb pain, fibromyalgia and migraine. Several underlying mechanisms are discussed, including the Adaptive Information Processing model and neurobiological mechanisms. Discussion The early findings should be interpreted carefully because they are based on reports with methodological limitations. These include the use of small sample sizes, heterogeneous samples and missing control groups that are discussed in this critical review. Moreover, some of the challenging questions remain unexplained, such as the focus of EMDR treatment, its dose-response relationship and its safety. It is also observed that not all patients respond to the EMDR treatment, which makes it essential to identify appropriate subgroups of chronic pain patients. Conclusion There is early evidence that EMDR treatment is successful in reducing chronic pain, but further research is required to account for the limitations of the findings observed in this critical review. Introduction Chronic pain is common and shows a high socioeconomic relevance1. However, most treatment approaches are characterised by a lengthy duration, high costs and only low-to-moderate effects2–4. Given this relatively modest treatment efficacy and the high social and economic costs of this condition, the exploration of new treatment methods is warranted in future studies. With respect to the treatment of chronic pain, the lack of positive effects might be a result of the nonspecific nature of the treatments being used for a heterogenic group of chronic pain patients. Thus, some chronic pain patients will respond to a particular treatment, while others will not. Therefore, almost a decade ago, development of subgroupspecific treatments was suggested5, but this remains a neglected issue in the research of chronic pain. One subgroup of chronic pain patients corresponds to patients experiencing high emotional distress, e.g. pain caused by psychological trauma (often reported in chronic pain6) and/or chronic pain itself. Recent studies show some evidence that Eye Movement Desensitisation and Reprocessing (EMDR), a treatment that targets emotional distress and the associated physical symptoms, can successfully reduce pain, in addition to trauma-related symptoms7. Therefore, EMDR might prove to be a promising approach in patients with high emotional distress, but without a history of trauma because there are manifold commonalities in patients with traumarelated symptoms and chronic pain8–10. Early studies support this assumption and show evidence that EMDR treatment could also benefit patients with chronic pain without a history of trauma11. The mechanisms that underlie the effectiveness of EMDR in chronic pain are still uncertain and controversial because there are several possible explanatory models. The aim of this critical review is to discuss EMDR in chronic pain conditions. Materials and Methods This paper is a critical review of pertinent articles concerned with the feasibility and usefulness of EMDR in the treatment of chronic pain. These articles were retrieved by regular selective literature searches that contained the terms ‘Eye Movement Desensitisation and Reprocessing’, ‘EMDR’ and ‘pain’. This review summarises the findings of EMDR for the treatment of chronic pain and also extracts potential theories that may explain the reason why EMDR is a promising treatment for chronic pain conditions. Findings and theories regarding the use of EMDR have been discussed in this review; and the implications for future research have also been derived.

Journal

English

Andreas Gerhardt
Wolgang Eich
Günter Seidler
Jonas Tesarz

Gerhardt, A., Eich, W., Seidler, G., & Tesarz, J. (2013, April). Eye movement desensitisation and reprocessing in chronic pain conditions. OA Musculoskeletal Medicine, 1(1), 7