Relaxation Techniques

Injury type: Acute/ Chronic

Category: Lifestyle Options

Rating: No research

What is it?

Relaxation techniques are tools for coping with stress and promoting long-term health by slowing the body and quieting the mind. Such techniques generally entail: refocusing attention (by, for example, noticing areas of tension); increasing body awareness; and exercises (such as meditation) to connect the body and mind. Used daily, these practices may over time lead to a healthier perspective on stressful circumstances and coping with pain.

How does it work?

A ‘relaxation response’ refers to changes that occur in the body when it is in a deep state of relaxation. These changes may include decreased blood pressure, heart rate, muscle tension and rate of breathing, as well as feelings of being calm and in control. Learning the relaxation response may help to counter the ill effects of the fight or flight response and, over time, allow the development of a greater state of alertness. The relaxation response may be developed through a number of techniques, including progressive muscle relaxation.

Is it effective?

There are a limited number of studies assessing the effectiveness of relaxation techniques for the management of whiplash. A systematic review¹ synthesised evidence on the effectiveness of psychological interventions highlighted a lack of clear evidence to support the use of relaxation training for persistent grades I-III whiplash. In this review, only one randomised controlled trial (RCT) was included to support this conclusion. In particular, this RCT reported similar outcomes between the brief relaxation training (guided imagery involving visualisation and listening to relaxation music) and acupuncture. When the study participants were provided with one session of each intervention, statistically but not clinically significant differences favouring acupuncture for trapezius muscle pain sensitivity were found, with no differences in disability, pain intensity or whiplash symptoms were reported.

Similarly, an RCT included in another systematic review² identified that when relaxation was included as part of multimodal care, there was a statistically but non-clinically significant improvement in self-rated disability in patients with recent grades I-III whiplash. Additionally, greater self-perceived benefit and reduction in workdays lost were identified in this RCT as a result of multimodal care in the short term (i.e. at four months post intervention).

Are there any disadvantages?

There are no reported disadvantages associated with relaxation.

Where do you get it?

Community groups often run relaxation classes. There are also therapists who teach relaxation. These are listed in the Relaxation Therapy section of the Yellow Pages.

Recommendations

The use of relaxation for whiplash cannot be recommended because of limited scientific evidence. More research is required.

References contributing to the treatment rating

American College of Physicians 2007, ‘Non-pharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society’, Annals of Internal Medicine, vol. 147, pp. 492-504.

Cotter, AC, Memmo, P & Kim, N 2002, ‘Complementary and Alternative Medicine in the Treatment of Whiplash Disorders’, in Whiplash, eds GA Malanga & S Nadler, Hanley and Belfus Inc., Philadelphia, pp. 373-391.

Edebol, H, Bood, S & Norlander, T 2008, ‘Chronic whiplash-associated disorders and their treatment using flotation-rest (restricted environmental stimulation technique)’, Qualitative Health Research, vol 18, no. 4, pp. 480-488.

Leaver, AM, Refshauge, KM, Maher, CG & McAuley, JH 2010, ‘Conservative interventions provide short-term relief for non-specific neck pain: a systematic review’, Journal of Physiotherapy, vol. 56, pp. 73–85.

Moore, A, Jackson, A, Jordon, J, Hammersley, S, Hill, J, Mercer, C, Smith, C, Thompson, J, Woby, S & Hudson, A 2005, Clinical guidelines for the physiotherapy management of Whiplash Associated Disorder, The Chartered Society of Physiotherapy, London.

1. Shearer HM, Carroll LJ, Wong JJ, Cote P, Varatharajan S, Southerst D, Sutton DA, Randhawa KA, Yu H, Mior SA, van der Velde GM. Are psychological interventions effective for the management of neck pain and whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. The Spine Journal. 2016 Dec 1;16(12):1566-81.

2. Sutton DA, Cote P, Wong JJ, Varatharajan S, Randhawa KA, Yu H, Southerst D, Shearer HM, van der Velde GM, Nordin MC, Carroll LJ. Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. The Spine Journal. 2016 Dec 1;16(12):1541-65.