Arthritis Today

Guided Imagery Brings Real Relief

Harness the power of the mind to address arthritis symptoms like pain and anxiety.


Guided imagery is a powerful tool in the fight against arthritis symptoms. Here’s how it works, in a nutshell: A person focuses on images – including symbols, pictures, scenes or even colors – that evoke feelings of relaxation or relief. The practice can help relieve physical pain and psychological symptoms such as stress, anxiety and depression, says Hilary McClafferty, MD, an expert on guided imagery at the Arizona Center for Integrative Medicine at the University of Arizona in Tucson.

“For example, if you have joint pain, you [would] use guided imagery to focus on joint pain, using the imagery to shrink, fade or soften the pain in your mind,” says Dr. McClafferty. “You directly focus on the pain, but in a positive way.”

Guided imagery may be useful to ease tension during arthritis drug infusions, for early intervention of symptom flares or to address emotional stressors. It should be used to complement, not replace conventional arthritis treatments like medications, Dr. McClafferty adds.

The practice may take as little as 10 to 20 minutes, and is done simply by focusing on mental images that elicit healing feelings – such as cooling hot joints, dulling pain, soothing soreness, softening stiff muscles, or relaxing stress and anxiety. Imagery differs from one person to another based on preferences, she says.

In the past decade, evidence supporting the efficacy of this practice has grown, especially for pain, anxiety and stress management. One recent study, published in March 2010 in Pain Management Nursing, followed 30 older adults with osteoarthritis (OA). After using guided imagery and relaxation techniques for four months, participants had less OA pain and greater mobility, and reduced their use of over-the-counter painkillers.

Convenience and low cost are two advantages of guided imagery, says Dr. McClafferty. People with arthritis can practice it when and where they like. CDs, videos or printed guides can help you learn how to practice guided imagery, and trained practitioners can provide personalized support. If using the imagination poses a risk – for those with a history of severe emotional, physical or sexual trauma, for example – consult a mental health professional before trying guided imagery, she stresses.

Here’s how to start,

  • Stop what you are doing
  • Find a quiet, private place
  • Close your eyes
  • Take several slow breaths to relax the body and focus the mind

Individuals may tailor the imagery to their needs and preferences – such as these examples.

Color Imagery

Problem: Pain in one area

Practice: Think of a color that you associate with pain, such as red, and picture the painful area of your body as red. Imagine shrinking, fading or dispersing the red, or even sending it away in a balloon. If you choose, repeat an affirmation like, “I am shrinking the red until it disappears,” until you feel the pain subside.

Symbol Imagery

Problem: Severe pain in one joint

Practice: Think about how the pain feels. Does it feel like a knife sticking in your joint? If so, imagine you are pulling the knife out of your joint and throwing it away. You may repeat an affirmation like, “I am removing the knife,” to help you focus on the pain and control it.

Scenic Imagery

Problem: Stress

Practice: Imagine a place that is calming to you, such as a comfortable lounge chair on a quiet beach. Think of the sounds of the waves, the feel of the warm breeze on your skin and the sand between your toes. Repeat an affirmation like, “I have nothing to worry about on this beach,” until your mind and body relax.

More Resources for Relief

When you’re learning how to practice guided imagery, Dr. McClafferty recommends using established resources. Audio CDs or videos, like those by Belleruth Naparstek at Health Journeys can help. Items available on the site include free, 15-minute, downloadable audio files on guided imagery. For personalized guidance, seek trained professionals certified by the Academy for Guided Imagery.  The American Society of Clinical Hypnosis also trains physicians and other health care professionals in guided imagery. Member referrals may be found on its website.

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