Complementary therapies for chronic knee pain: A placebo-controlled RCT of Reiki and mindfulness

CONTEXT: Knee osteoarthritis (KOA) is a prevalent chronic pain condition that significantly impairs quality of life and is often treated with interventions that carry risks or provide limited relief. Reiki, a non-invasive complementary therapy, has shown early promise for pain management but lacks rigorous evaluation among American adults with KOA. OBJECTIVES: This study evaluated the specific efficacy of Reiki and mindfulness for adults with chronic KOA pain compared to sham and waitlist control conditions. METHODS: In this placebo-controlled randomized trial, 164 adults with physician-confirmed KOA were assigned to one of four groups: Reiki, sham Reiki (i.e., Feiki), mindfulness meditation, or a waitlist control. Active treatments were delivered in four weekly 30-minute sessions. RESULTS: KOA symptom severity, assessed using the WOMAC at baseline, 1-month, and 2-month follow-ups, significantly improved in both the Reiki (p = .02) and mindfulness (p < .001) groups compared to waitlist controls. Mindfulness significantly outperformed Feiki (p = .004). Reiki demonstrated effects comparable to mindfulness (p = .22). Clinically meaningful reductions in symptoms (>30 %) were reported by 55 % of participants in the Reiki and mindfulness groups, compared to 20 % in the Feiki group and 13 % in the waitlist group. High retention (96 %) and successful blinding support the feasibility and internal validity of this approach. CONCLUSIONS: These findings indicate that both Reiki and mindfulness may offer effective, well-tolerated, and time-efficient alternatives for managing KOA-related pain, with meaningful symptom improvement after just two hours of intervention. Larger trials are warranted to confirm efficacy and explore long-term outcomes and underlying mechanisms.