Self-managed Complementary and Integrative Health Approaches for Chronic Pain and PTSD: An Umbrella Review
Belle Zaccari1,2,3, Travis I Lovejoy4,5,6, Vanessa Somohano4,5,6
1Center to Improve Veteran Involvement in Care, Veterans Affairs Portland Health Care System, Portland, OR, USA. belle.zaccari@va.gov.
Journal of General Internal Medicine
|July 16, 2026
Summary
Self-managed complementary and integrative health (CIH) interventions like yoga and meditation show potential for chronic pain and PTSD. These approaches may offer effective symptom reduction with a low risk of adverse events.
Area of Science:
- Integrative Medicine
- Psychiatry
- Pain Management
Background:
- Chronic pain and posttraumatic stress disorder (PTSD) share overlapping pathophysiology.
- Complementary and integrative health (CIH) interventions are increasingly studied for these conditions.
- Numerous systematic reviews and meta-analyses (SR/MAs) exist for CIH interventions.
Purpose of the Study:
- To describe and evaluate SR/MAs of self-managed CIH modalities for chronic pain or PTSD.
- To assess the efficacy and safety of CIH interventions for comorbid chronic pain and PTSD.
Main Methods:
- Umbrella review methodology adhering to PRISMA guidelines.
- Searched multiple databases (MEDLINE, PsycInfo, Cochrane) for SR/MAs of RCTs published from 2017 onwards.
- Assessed methodological quality of SR/MAs using the Revised Assessment of Multiple Systematic Reviews Tool.
Main Results:
- Included 27 SR/MAs (16 for chronic pain, 11 for PTSD) covering yoga, meditation/mindfulness, and tai chi/qigong.
- Methodological quality of included SR/MAs was generally high (29-42/44 points).
- Efficacy varied by condition and intervention; mild, temporary adverse events were possible.
Conclusions:
- Self-managed CIH interventions are well-documented for chronic pain and PTSD.
- CIH may be effective for individuals with comorbid chronic pain and PTSD, with a low risk of adverse events.
- Mindfulness and movement-based interventions are recommended for simultaneous treatment of chronic pain and PTSD.
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