Reiki for Relaxation and Pain Relief

By Dónal P. O'Mathúna, PhD, Lecturer in Health Care Ethics, School of Nursing, Dublin City University, Ireland. Dr. O'Mathúna reports no consultant, stockholder, speaker's bureau, research, or other financial relationships with companies having ties to this field of study.

The term "Reiki" (pronounced "ray-key") comes from two Japanese words, rei, meaning universal spirit, and ki, meaning life energy.1 Other therapies based on the existence of such non-physical, vibrational life energy (or aura) include Therapeutic Touch (the energy being called prana) and the traditional Chinese medical interpretation of acupuncture (based on chi). Interest in Reiki has been growing, leading to increased use within conventional healthcare settings.2,3 Health care professionals should be informed about Reiki to answer patients' questions regarding the therapy and to help them decide whether to incorporate it into their practices.

Common Usage

Reiki is used to promote healing, wholeness, and enlightenment. However, other proponents claim Reiki can be used for many other conditions, such as "treating heart attacks, emphysema, varicose veins, hemorrhoids, prostate problems, hiccups, nosebleeds, accidents, and emotional and mental problems."4 The difficulty in evaluating these claims is that very little controlled research has been conducted on Reiki.1

Historical Background

Reiki is an ancient healing practice, believed to have originated thousands of years ago in Tibet.1 It was rediscovered in Japan by a Buddhist monk, Mikao Usui, during the mid-1800s. Reiki is still practiced according to the Usui System, although many variations also exist. Usui first experienced Reiki during a spiritual experience on a Japanese mountaintop after fasting for 21 days.5 One of his disciples trained Mrs. Hawayo Takata, who introduced Reiki to the Western world around 1940. Only Mrs. Takata was allowed to teach Reiki in the West until 1975. Since then, knowledge and practice of Reiki has grown substantially, with one report claiming more than 1 million practitioners have been initiated in recent decades.6

Mechanism of Action

Reiki is based on the belief that all life depends on a universal, non-physical energy. Health requires a sustained and balanced flow of this energy throughout the body. Disturbances result in physical, emotional, or mental problems. Reiki allegedly corrects life energy imbalances and blockages, making people aware of the life energy flowing through them.

During Reiki, people report a variety of experiences described in qualitative research as "liminal,"7 by this is meant various altered states of consciousness, paradoxical sensations (such as simultaneously feeling heavy and weightless), disorientation to time, and sensations of energy. The latter descriptions of people's experiences with Reiki point to a controversy surrounding its practice. The researchers noted that, "Liminal states of consciousness…are frequently associated with profound religious experience and have been linked to ritual healing practices across cultures."7

Such experiences, coupled with the therapy's origins, have raised concerns that Reiki is more like a religious practice than a healing therapy. For example, the International Center for Reiki Training states: "It is the God-consciousness called Rei that guides the life force called Ki in the practice we call Reiki. Therefore, Reiki can be defined as spiritually guided life force energy."8 Another practitioner states that training is believed "to connect the student to primordial consciousness, the intelligence that permeates creation."3 Others claim "Reiki is not a religion or cult. It is considered a natural spiritual discipline with intrinsic elements of respect, harmony, and compassion."1 Many descriptions generate further confusion by failing to clarify what they mean by the terms used.


When receiving Reiki, a person relaxes in any position. Practitioners gently rest their hands in specific ways on approximately 12 standard sites throughout the body, which vary among practitioners. Reiki practitioners begin with the head and spend a few minutes at each site, with a complete session taking 45-90 minutes.

Practitioners are believed to act as passive channels for the life energy, which comes from a universal source. According to many practitioners, the energy cannot be guided by the human mind but appears to have an intelligence of its own.9 The energy thus guides itself, going where it is needed as determined by the patients' needs.1 More advanced practitioners claim they do not need to be present with patients but can bring healing by visualizing their patients (called distance Reiki).

Practitioner Training

Reiki training involves opening trainees' life energy channels (or chakras) in special training sessions called initiations, empowerments, or attunements.3 Only Reiki Masters (or Level III practitioners) may perform attunements, also described as sacred ceremonies.1,3,5 During attunements, trainees' hands become warm, signaling they are ready to channel life energy as Level I practitioners.

Reiki Level II is attained during a unique attunement when the practitioner intuitively receives special symbols, believed to be healing gifts from personal spiritual beings called spirit guides.5,10 The symbols increase the practitioner's healing powers. Practitioners draw the symbols on patients' bodies, or visualize them, while silently chanting the symbol's name. Level II must be attained before distance Reiki is possible.4,5 Becoming a Reiki Master requires another attunement during which additional symbols are received for use in initiating trainees.

Clinical Studies

Many beneficial effects are claimed, but these are based primarily on anecdotal reports and descriptive studies.9 Two studies hypothesized that Reiki would change the blood's oxygen-carrying capability as reflected by hemoglobin and hematocrit levels.11,12 Two other studies measured subjects' anxiety levels using physiological measurements.1,13 These studies found significant differences before and after Reiki, but they either had no control group or used one which differed significantly from the treatment group. The changes could thus have been due to the placebo effect.

A small number of clinical studies have been conducted with patients. An uncontrolled pilot project used Reiki with 20 subjects experiencing different types of moderate pain.14 Subjects continued to use other analgesics and received Reiki in a dimly lit room accompanied by burning candles and soft music. Pain scores were significantly lower after therapy compared to immediately before therapy.

This pilot study led to a controlled trial of patients with advanced cancer.15 Sample size calculations showed that 100 participants were needed to detect adequate pain reduction. The trial was stopped after 53 patients were recruited because participants insisted on being assigned to the Reiki group despite being informed of the lack of documented evidence of benefit. Participants were randomly assigned to either standard opioid drugs plus 90 minutes Reiki (including physical touch) or opioids with 90 minutes rest (with no physical touch). Before and after the interventions, given on days 1 and 4, a research nurse measured pain scores, blood pressure, respiration rate, and heart rate. On days 1 and 7, quality of life and analgesic usage were measured.

Only 24 patients completed the study (55% dropout). On days 1 and 4, pain reduction was significantly greater with Reiki than control (P = 0.035 and 0.002, respectively). Diastolic blood pressure and heart rate were significantly lower with Reiki on day 1, but not day 4. Systolic blood pressure and respiration rate did not differ significantly on either day. The psychological component of the quality-of-life measurements improved significantly in the Reiki group, but not the social or physical components. Analgesic usage did not differ between the groups. The researchers urged caution in interpreting the results due to the small sample size, high drop-out rate, and the confounding influence of the Reiki practitioner's presence and touch in the Reiki group.

One study reported faster wound healing in the control group compared to subjects receiving a combination of Reiki, Therapeutic Touch, Intercessory Prayer, and LeShan (a distance healing technique said to raise people's conscious awareness of healing processes).16 Three Reiki practitioners treated 15 healthy subjects recruited from relaxation courses.10 Distance Reiki was used to either induce relaxation or arouse subjects' autonomic activity for 30-second intervals in a randomly determined sequence (25 minutes altogether). Skin resistance response was used as a measure of relaxation, but responses did not differ significantly between relaxation or arousal periods. In another study, nursing students received either hands-on Reiki (n = 22) or mimic-Reiki (n = 20).17 No significant differences were found for perceptions of anxiety, personal power, or well-being using two questionnaires.

A controlled study randomized 21 patients to treatment or control (no intervention) after impacted third molars were extracted.18 Three hours later the treatment group began receiving distance Reiki and LeShan from "several" miles away, with practitioners alternating therapies every hour for six hours. Two weeks later, the second lower third molar was removed and subjects crossed over to the other group. Pain intensity was evaluated hourly, subjectively. The treatment group had significantly lower pain intensity and significantly higher pain relief.

Another controlled study involved patients in rehabilitation after stroke.19 Thirty patients were randomly assigned to one of three groups and the records of 20 other stroke patients were used as a control group. The treatment groups received the same procedure from a Reiki master or Reiki level I practitioner or practitioners trained in Reiki procedures who had not been given attunements. Each participant received up to 10 treatments over 2.5 weeks. A standardized depression assessment tool and a rehabitiation tool measuring cognitive and physical functions found no difference between any of the groups.

A controlled study of Reiki randomly assigned 45 patients needing treatment for depression and stress to receive hands-on Reiki, distance Reiki, or mock-distance Reiki.20 The hands-on Reiki participants were told they received mock Reiki and the mock-Reiki group was told it received distance Reiki. Participants received one treatment per week for six weeks. Three standardized assessment tools measured depression, hopelessness, and stress at weeks 1, 6, and 52. At weeks 6 and 52, both treatment groups showed significant improvement on all three tests compared to control. The two treatment groups did not different significantly from one another on any test.

Adverse Effects

No adverse effects have been reported in studies. Proponents claim Reiki cannot cause harm as the energy adjusts itself as needed. One proponent claims overdosing is precluded and "there is ultimately no wrong technique."3 An Australian nursing journal printed a letter claiming Reiki training caused a nurse much anxiety and discomfort.21 A storm of controversy erupted, with some nurses reporting negative effects and others defending Reiki as completely harmless.22 However, caution should be exercised given the types of experiences reported after Reiki.7 Such changes in states of consciousness and time perceptions have led to psychological problems in people receiving other complementary therapies.23


The few controlled studies of Reiki have diverse designs and often include other therapies. Confounding factors could account for the improvements found. Reiki's growing popularity probably reflects the importance of meaningful, personal interactions between health care providers and patients. Controversy regarding Reiki's spiritual roots, and the secrecy associated with aspects of Reiki, require caution. Patients should be informed that Reiki has little evidence supporting its effectiveness and told about the controversy surrounding its spiritual roots. This information is essential so that patients can make informed decisions about the therapeutic and spiritual aspects of Reiki.


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