Effects of Nature-Based Multisensory Stimulation on Pain Mechanisms in Women with Fibromyalgia Syndrome: A Randomized Double-Blind Placebo-Controlled Trial

Pain Manag Nurs. 2024 Feb;25(1):46-55. doi: 10.1016/j.pmn.2023.06.014. Epub 2023 Jul 24.

Abstract

Background: The term "nature-based sensory stimuli" refers to the sensory information produced by biotic and abiotic agents from natural environments. The literature has reported the beneficial effects of these agents on various pain dimensions in non-clinical populations.

Aims: To evaluate the potential analgesic effects of nature-based multisensory stimulation in women with fibromyalgia syndrome.

Methods: A randomized, double-blind, placebo-controlled, parallel-group trial with a 1:1 allocation ratio was conducted. Forty-two women with fibromyalgia syndrome interacted with either different plant species with flowers, stones, and soil organic matter or their synthetic imitations for 30 minutes. Outcome measurements were performed before and after the intervention, including clinical pain intensity using the Numeric Rating Scale, cold pain thresholds using the Cold Pressor Test, mechanical hyperalgesia and wind-up using a monofilament, and pressure pain thresholds using a pressure algometer.

Results: Analyses revealed group × time interactions for clinical pain intensity (F = 7.915, p = .008), cold-water immersion time (F = 7.271, p = .010), mechanical hyperalgesia (F = 4.701, p = .036), and pressure pain threshold (p ≤ .017). Between-group differences were found in clinical pain intensity (p = .012), cold pain thresholds (p = .002), and pressure pain thresholds (p < .05). The experimental group exhibited reduced clinical pain intensity (p = .001) and increased pressure pain thresholds (p ≤ .034).

Conclusions: Women with fibromyalgia syndrome may benefit from multisensory stimulation using biotic and abiotic agents from natural environments for 30 minutes. Interacting with flowering plants and soil components appears to induce analgesic effects.

Keywords: Chronic primary pain; Fibromyalgia; Multisensory stimulation; Nature-based activities; Quantitative sensory testing.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesics / pharmacology
  • Double-Blind Method
  • Female
  • Fibromyalgia* / complications
  • Fibromyalgia* / therapy
  • Humans
  • Hyperalgesia
  • Pain / drug therapy
  • Pain Threshold / physiology
  • Soil

Substances

  • Analgesics
  • Soil