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Baumgartner JN, Quintana D, Leija L, et al. Widespread pressure delivered by a weighted blanket reduces chronic pain: A randomized controlled trial. J Pain. 2021 Aug 20. pii: S1526-5900(21)00313-8. doi: 10.1016/j.jpain.2021.07.009. (Original study)
Abstract

Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket - providing widespread pressure to the body - relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.

Ratings
Discipline Area Score
Psychologist 7 / 7
Rehab Clinician (OT/PT) 5 / 7
Physician 5 / 7
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Comments from MORE raters

Physician rater

This is a very unusual study: 94 adult subjects with chronic pain received a 15-pound blanket instead of a light blanket as a non-drug intervention. Sleep quality and pain perception improved under the heavier quilt. Now, such an experimental design cannot be blinded. In this respect, it can be safely assumed that before it can be generally recommended to cover oneself with a heavier blanket, the result of this study must be validated by further investigations.

Psychologist rater

It would be helpful to have more specific information.

Rehab Clinician (OT/PT) rater

Although the 15# weighted blanket demonstrated positive modulation on perception or the affective aspects of chronic pain experienced, there were no significant changes in pain intensity, anxiety, nor sleep outcomes diminishing benefits from prescribing the weighted blanket. Based on authors' results, using weighted blanket for anxious patients within a pain management facility utilizing multi-modal biopsychosocial interventions may be considered. As a physical therapist I do not recommend the weighted blanket as a stand-alone treatment.

Rehab Clinician (OT/PT) rater

Some patients with chronic pain have such an upregulated nervous system that the pressure from weighted blankets are not easily tolerated. As with any intervention studied, it's best not to generalize too much or to make a blanket statement/too broad of a conclusion.
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