PEP Topic 
Chronic Pain

Reiki (pronounced "RAY-kee") is a form of energy healing that uses vibration drawn through the practitioner into the recipient, in accordance with the recipient’s need. Proponents hypothesize that Reiki reestablishes the energy balance in areas of the body associated with discomfort, thus promoting healing and increasing quality of life. Researchers have evaluated Reiki in patients with cancer for its impact on anxiety, depression, pain, and fatigue.

Effectiveness Not Established

Research Evidence Summaries

Birocco, N., Guillame, C., Storto, S., Ritorto, G., Catino, C., Gir, N., . . . Ciuffreda, L. (2012). The effects of Reiki therapy on pain and anxiety in patients attending a day oncology and infusion services unit. American Journal of Hospice and Palliative Care, 29, 290–294.

doi: 10.1177/1049909111420859

Study Purpose:

To examine the effects of Reiki on pain, anxiety, and global wellness among patients with cancer who are receiving chemotherapy

Intervention Characteristics/Basic Study Process:

Reiki sessions were offered to patients in a day oncology and infusion services unit that provided chemotherapy. Patients sat in a chair or lay on a bed during Reiki sessions. Each session lasted approximately 30 minutes. Each patient received a maximum of four Reiki sessions. Prior to each session, Reiki practitioners assessed levels of anxiety and pain according to a numeric scale. After each session, levels of pain and anxiety were recorded on a visual analog scale. The study was done over three years.

Sample Characteristics:

  • The study reported on a sample of 118 patients, but only 22 completed all sessions.
  • Mean patient age was 55 years, with a range of 33–77 years.
  • The sample was 57% male and 43% female.
  • Patients had various types of cancer, and all were receiving chemotherapy.


  • Single site
  • Outpatient setting
  • Italy

Phase of Care and Clinical Applications:

Patients were receiving active antitumor treatment.

Study Design:

A prospective pre/post-test design was used.

Measurement Instruments/Methods:

  • Numeric rating scale
  • Visual analog scale (VAS)


Only 48% of patients had more than one Reiki session, and only 22 patients (17%) completed four sessions and were included in statistical analysis. From session 1 to session 4, mean anxiety scores post-Reiki session declined, but scores immediately after each time point were higher than those reported immediately prior to the session.


Findings of this study do not support the effectiveness of Reiki. The study included numerous limitations in study design and methods.


  • The study had a small sample size, with fewer than 30 participants.
  • The study had risk of bias due to no control group, no blinding, and no random assignment.
  • Measurement validity/reliability was questionable.
  • The intervention was expensive, impractical, or presented training needs.
  • The study reported that pre-session measures, on a numeric scale, were collected by Reiki providers and that post-session measures, per a VAS, were collected by the practitioner. These are two different scales that cannot be directly compared. The study does not make clear what the actual data scale was or the size of the VAS, for interpretation of data.
  • Scoring was done by the Reiki practitioners, which could introduce bias. Reiki practitioners required two years of training, one year of additional workshops, and one year of in-hospital practice with tutors.

Nursing Implications:

 This study does not support the effectiveness of Reiki. The study and methods were not well designed or reported.

Systematic Review/Meta-Analysis

Gonella, S., Garrino, L., & Dimonte, V. (2014). Biofield therapies and cancer-related symptoms: A review. Clinical Journal of Oncology Nursing, 18, 568–576. 

doi: 10.1188/14.CJON.568-576


STUDY PURPOSE: To review the evidence regarding the effects of biofield therapies for relief of cancer-related symptoms
TYPE OF STUDY: Systematic review

Search Strategy:

DATABASES USED: PubMed, CINAHL, PsycINFO, Trip database, and Cochrane Collaboration
KEYWORDS: Not provided 
INCLUSION CRITERIA: Cancer diagnosis; age > 18 years old; undergoing biofield therapies (BT) to relieve cancer-related pain, anxiety, and fatigue, or to increase well-being and quality of life
EXCLUSION CRITERIA: Studies related to surgical pain were excluded

Literature Evaluated:


Sample Characteristics:

  • SAMPLE RANGE ACROSS STUDIES = 16–230 patients
  • KEY SAMPLE CHARACTERISTICS: Various tumor types, patients in active treatment undergoing chemotherapy or radiation therapy

Phase of Care and Clinical Applications:

PHASE OF CARE: Active antitumor treatment
APPLICATIONS: Palliative care 


Interventions considered to be BT were healing touch, Reiki, and therapeutic touch. The effect on pain was examined in seven studies. There were some mixed findings, but most showed a reduction in pain over short time periods. Fatigue was assessed in five studies. These demonstrated fatigue reduction post-treatment, but data were conflicting over a longer period of four to eight weeks. Anxiety and depression were examined in seven studies. All but one found a significant reduction in mood disorders, but a study comparing Reiki, sham Reiki, and usual care found no difference between the sham and actual Reiki groups. Most studies were of descriptive or quasi-experimental design; potential confounding variables were not examined, and placebo effects could not be ruled out.


Studies using biofield therapies for relief of pain, anxiety, fatigue, and depression generally showed benefit; however, the evidence is not strong due to the limitations of the studies included.


Low-quality design studies and the short duration of study follow-up

Nursing Implications:

BT therapies have not demonstrated effectiveness in well-designed clinical studies; however, though it is weak, evidence suggests potential benefit. There were no adverse effects of these interventions reported. Biofield therapies are not expensive and are low-risk, so they can be considered in the management of cancer-related symptoms. Well-designed clinical trials are needed to establish efficacy.