Reiki for Relaxation and Pain Relief

By Dónal P. O’Mathúna, PhD

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 a non-physical life energy include Therapeutic Touch (the energy being called prana)2 and the traditional Chinese medical interpretation of acupuncture (based on chi).3 Patients will ask about Reiki, and some medical professionals will consider incorporating Reiki into standard care. Nurse clinicians need some knowledge of this therapy.

Common Usage

Reiki is an alternative manual healing therapy growing in popularity among clinicians, especially nurses. Reiki can be used "for treating heart attacks, emphysema, varicose veins, hemorrhoids, prostate problems, hiccups, nosebleeds, accidents, and emotional and mental problems."4 Most commonly, Reiki is used to promote healing, wholeness, and enlightenment. A survey of Canadian Reiki patients reported using it primarily for emotional difficulties and self-development.5 Conventional journals have carried articles recommending Reiki to improve patient well-being.1,6,7 One hospital already does so for all preoperative patients, except those of one dissenting physician.8 Numerous hospitals and health care agencies have conducted Reiki in-services.9

Historical Background

Reiki is an ancient Buddhist practice, rediscovered in Japan by Mikao Usui during the mid-1800s. Reiki is still practiced according to the "Usui System." Usui allegedly earned a theology doctorate from the University of Chicago and was principal of Doshisha University in Japan. No records exist of his involvement in any capacity with either university.10

Usui entered a Buddhist monastery searching for insight into healing. Reiki was revealed to Usui during a spiritual experience on a Japanese mountaintop after fasting for 21 days.10 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.4

Mechanism of Action

Reiki is based on the belief that all life depends on a universal, nonphysical 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. The following description from one of Mrs. Tanaka’s disciplines is typical: "Reiki is a natural consciousness-expanding technique that will put you in touch with your real self—with your own eternal being."4

Whether Reiki is a healing therapy or a religious practice is uncertain, as the International Center for Reiki Training’s description demonstrates: "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."11


A person relaxes in any position to receive Reiki. Practitioners gently rest their hands in specific ways on approximately 12 standard sites throughout the body, which may vary slightly among practitioners. Reiki practitioners begin with the head and spend a few minutes at each site, with a complete session taking 60 to 90 minutes. Eventually, practitioners may expand the therapy beyond the standard 12 sites.

More advanced practitioners claim to be as effective when physically absent from patients, simply visualizing their hand movements with patients (called distance healing). Practitioners are believed to act as passive channels for the life energy, which comes from its universal source. Practitioners do not direct the energy, which guides itself solely to where it is needed.

Practitioner Training

Reiki training involves opening trainees’ life energy channels (or chakras) in special training sessions called "attunements." Only Reiki Masters (or Level III practitioners) may perform attunements, viewed by many as "sacred ceremonies."9,10,12 The Master makes special hand movements around the trainee to open the energy channels. Trainees’ hands become warm, signaling they are ready to channel life energy as Level I practitioners.

After some experience, Reiki Level II can be attained with another attunement when the practitioner "intuitively" receives special symbols, believed to be healing gifts from personal beings called spirit guides.10,13 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 Reiki distance healing is possible.4,10 Becoming a Reiki Master re-quires another attunement during which additional symbols are received for use in the Level I initiation rituals.

Clinical Studies

Literature searches for "Reiki" in MEDLINE, CINAHL, Dissertation Abstracts, the Cochrane Library, and the Registry of Nursing Research revealed four clinical trials, with their references leading to three more. Two hypothesized that Reiki would change the blood’s oxygen-carrying capability as reflected by hemoglobin and hematocrit levels with mixed results.14,15

One examiner reported slower wound healing in patients receiving a combination of Reiki, Therapeutic Touch, LeShan (a distance healing technique said to raise people’s conscious awareness of healing processes), and Intercessory Prayer.16 After 10 days, one of 15 subjects given 4 mm skin biopsy wounds and treated was fully healed, compared to seven fully healed out of 15 untreated subjects.

Two studies tested the widespread claim that Reiki powerfully induces relaxation. The first used distance Reiki to induce relaxation monitored by skin resistance response (SRR) measurements.13 Three Reiki practitioners treated 15 healthy subjects recruited from relaxation courses at the researchers’ institute. Practitioners attempted to either relax or arouse subjects’ autonomic activity for 30-second intervals in a randomly determined sequence (25 minutes altogether). SRR changes during relaxation or arousal intervals did not differ significantly. In the other 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 questionnaire instruments.

Two clinical studies examined Reiki’s pain-relieving effects. Impacted third molars were extracted from 21 patients in a randomized, double-blind, within-subject crossover study.18 Subjects were randomly assigned to one group for the removal of one lower third molar, and about two weeks later crossed over to the other group for the removal of their second lower third molar. Subjects took 1,000 mg acetaminophen orally at 3, 6, and 9 hours postoperatively. Practitioners were "several miles" away and commenced either Reiki or LeShan treatments at hour 3, alternating hourly for six hours. A visual analogue scale assessing pain intensity and a Likert scale assessing pain relief were administered hourly from hour 3 to 9 (subjects unsupervised at home). The treatment group had significantly lower pain intensity and significantly higher pain relief at hours 4 through 7 (P < 0.05) and hours 8 and 9 (P < 0.01).

A pilot project used hands-on Reiki with 20 subjects experiencing moderate pain at 55 sites for a variety of reasons.19 Subjects used various pharmaceutical and alternative pain reducing therapies concurrently. Reiki was administered in a dimly lit room accompanied by burning candles and soft music. Pain scores were significantly lower after therapy compared to immediately before therapy (2.25 reduction on a visual analogue scale; 1.25 reduction on a Likert scale; P < 0.0001). A control group was not used.

Adverse Effects

No patient adverse effects have been reported. Proponents claim Reiki cannot cause harm as the energy adjusts itself to provide only the needed effects. An Australian nursing journal printed a letter claiming Reiki training caused a nurse much anxiety and discomfort.20 A storm of controversy erupted subsequently, with some nurses reporting similar negative effects and others defending Reiki as completely harmless. 21


The few Reiki studies have diverse designs and often include other therapies. Confounding factors could account for the improvements found. The authors of one Reiki study concluded: "Despite the growing interest in Reiki, no strong evidence is yet available regarding its effectiveness."12


Reiki’s growing popularity probably reflects the importance of meaningful, personal interactions between healthcare providers and patients. Controversy regarding Reiki’s spiritual roots, and the secrecy associated with many aspects of Reiki, require particular caution before suggesting Reiki to patients. v


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