Treatments and interventions addressing chronic somatic pain in torture survivors

Torture survivors experience chronic, somatic pain that may be exacerbated by environmental, social, and structural factors that extend beyond immediate traumatic events and diagnoses. We conducted a systematic review of research describing the types and efficacy of treatments for chronic somatic pain in a global population of torture survivors. In this systematic review, we searched Ovid MEDLINE, Ovid EMBASE (1974 to present), and PubMed. We used all appropriate controlled vocabulary and keywords for interventions and treatments for chronic somatic pain in torture survivors. The population included survivors of torture of any age and in any country. Outcomes included pain relief, pain intensity, distress level, and quality of life. Four authors participated in screening, full-text review, and quality assessment, with each title and abstract being independently reviewed by two authors. This study is reported according to the PRISMA guidelines and registered in PROSPERO. We included six pre-post intervention studies and four pilot or modified randomized controlled trials (RCTs), for a total of ten studies included in the analysis. Different combinations of interventions targeted pain reduction in refugees, the majority of whom were torture survivors as the primary (n = 1) or secondary (n = 9) outcome. Sample sizes varied from eight to 470 participants. We identified three main types of interventions: multimodal combined, manual therapy, and specific types of talk therapy. Five studies demonstrated positive outcomes on pain and its intensity, three reported no effect, and two had mixed outcomes. Pain in torture survivors is often considered a symptom secondary to mental health illness and not targeted directly. Instead, combined interventions are mainly directed at posttraumatic stress disorder (PTSD), depression, and anxiety. Most studies noted promising preliminary results and plans to conduct RCTs to increase the reproducibility and quality of their pilot data

• Association of Torture and Other Potentially Traumatic Events With Mental Health Outcomes Among Populations Exposed to Mass Conflict and Displacement

  Zachary Steel, Tien Chey et al.•JAMA•2009

  Add to list

• The PRISMA 2020 statement

  Open Access•Matthew J Page, Joanne E McKenzie et al.•BMJ•2021

  Add to list

• Female genital mutilation/cutting and birthing

  Open Access•Jacob M Lurie, Jacob Lurie et al.•Journal of Global Health•2022

  Add to list

• A novel bio-psycho-social approach for rehabilitation of traumatized victims of torture and war in the post-conflict context

  Open Access•Shr-Jie Wang, Ardiana Bytyçi et al.•Conflict and Health•2016

  Add to list