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To study and determine the educational needs of nurses after graduation in order to make them further capable, aims at promotion of their occupational standards and betterment of this profession. By means of this study we can identify their needs and make necessary planning to reduce the resultant shortcommings and problems. The present research is a descriptive and analytical study conducted to survey the educational needs of nurses regarding non-pharmacological methods of controlling chronic pans in patients at medical surgical wards of the hospitals of Tehran University Medical of Sciences. A total of 119 nurses working at one of these wards participated in this research. The tool for gathering the information was a three-part questionnaire. The first part deal with individual particulars, the second part was about questions regarding the feeling needs of nurses an the third part was about questions regarding the educational needs of nurses. The findings showed: As for the feeling needs, nurses needed training , as for the level of educational needs regarding the concept of pain (69.7%), characteristics of chronic pains (52.9%), guided imagery method (50.4%) of nurses were in need of a high level of training and regarding the progressive muscle relaxation (68.9%) of nurses were in need of a medium level of training. The results revealed the connection between some individual particulars with the level of educational need, to the extent the age, clinical work experience, work experience in medical and surgical ward and the type of ward affected the level of educational need, and by using the Pearson Coefficient a meaningful statistical difference appeared, in other words, as the years of service increases , the level of knowledge decrease and the educational needs rise up.

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Sleep is not often used to indicate Pain Relief in infants.If Infants and childeren "s sleep Patterns are Distured by Painful Procedures they dont experience Restful sleep . Further more if Pain and lack of sleep are Continuous, other more global! Functional beheriors Such as Sociability and Consolability may be affected because lack of and disturbed sleep were Cues of infant Pain.There fore if rest Ful sleep is increased, Pain is decreased. Similar Study in adults were observed that who received Patient Controlled analgesia had less nocturnal awakehing and less interference with spontaneous move ment such as moving and walking secandory to build and repair tissue.Several abutt studise Provide evidence of tissue remeval a ssocited with release of the growth hormone during deep sleep and %70 of the total Secretion of this hormone occurs during sleep .in this Case Study infant 's increased sleep was used as an indicator of Pain relief for an 8-month old female infant with respiratory Failure Secondary to Sepsis. A sleep activity record documented total hours of sleep and longest hours of Sleep after nonana Igesic and analgesic interventions to mediate the infant 's Pain, sleep appeare to be a useful indicator of the afficacy of pain treat ment for infants.

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Post-surgery pain is usually controlled by PRN drugs administered by nurses. According to the decision-making theories, this clinical decision-making depends on three factors: nurse-related factors child-related factors and hospital-related factors. This study deals with the first and second factors mentioned. This descriptive-analytic study aims at determining the perspective of nurses on factors which affect their decisions to administer the analgesic PRN to children after surgery in several chosen hospitals of Tehran. The study used a standardized questionnaire to collect data from 57 nurses in pediatric surgery wards. The questionnaire consisted of three parts: 1) nurses demographic data 2) 20 clinical scenario for nurses to make a decision for prescribing either analgesic medication, non-analgesic medication or no medication where necessary and 3) 12 factors which affect clinical decision-making in using analgesics.(in prioritizing among the above mentioned). The results show that factors such as age, nursing experience, pediatric nursing experience and motherhood were significantly related to choosing to use analgesics. Education and personal experience of extreme pain was also related to the type of analgesic chosen. Concerning the specifics of the children there was a significant difference between the choice to use analgesics and the type of analgesic used according to the various ages of the children. There was also a significant relationship between the type of surgery and the time of surgery and with the choice to use analgesics and the type of analgesics used, such that medication and analgesics were administered more frequently for complicated surgeries and in first 24 hours after surgery. Type of surgery, severity of pain, time of surgery and uneasy behaviors were selected respectively as the most effective in the administration of PRN analgesic drugs. Nurse and child related factors strongly influence nurses in making decisions to administer PRN analgesics postoperatively.

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Introduction: Pain caused by some therapeutic and nursing procedures has been a major concern of health care providers. Injection pain is a common complaint of patients. Materials and

Methods: This quasi-experimental investigation was conducted to compare the pain intensity caused by standard, and Z-Track method for intramascullar (I.M) injection. The samples were 100 female nursing student volunteers that were selected by convenience sampling. Each sample was injected two times blindly: first by standard and then by Z-Track method, with 24 hours interval. None of them knew the method of injection for each time. The injection solution was 1 ml sodium chloride. Pain intensity was measured by a numerical pain assessment scale and pain experienced by every body was compared with herself.

Results: The results showed that the pain associated with IM injection was significantly decreased when Z-Track method was used.

Conclusion: The researcher can join to other authors stating that Z-Track can be the technique of choice for all I.M injections.

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Introduction: Low back pain is a very common complaint in communities as about 80% of people experience it throughout their life. Low back pain has negative effects on different aspects of the patients lives. One of the palliative treatments of low back pain is accupressure.

Materials and Methods: A single blind clinical trial study was conducted to evaluate the effects of accupressure on low back pain in Khorram Abad city Tamin Ejtemaei hospital in 2002. Ninety patients were selected by convenience sampling and then they randomly divided into three groups: Experimental (accupressure was applied in real points), plasebo (sham accupressure was applied in four shampoints) and control (without any intervention). The subjects were 36 males and 54 females, ranging in age from 20-50 years. All three groups used Acetaminophen tablet (325 mg) for pain relief. Data were collected by an structured questionnaire, pain assessment numerical scale and three self reported scale.

Results: The results of study indicated that accupressure and sham accupressure could alleviate low back pain severity, but reduction of pain was statistically significant only in experimental group (p<0.0001). Decline in the amount of medication usage in experimental group was statistically significant (p<0.0001).

Conclusion: In conclusion, the study showed use of accupressure was effective on pain relief and it can be used as a safe treatment.

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Background & Aim: The severe pain of labor is the important cause of fear and anxiety in pregnant women. This study has been performed to evaluate effect of education on midwives practice.

Methods & Materials: This is a quasi-experimental study. That was done 59 midwives in the labor wards of non-educational of Guilan University of Medical Sciences Hospital. Data gathered by a questioner, which its validity was done by panel of experts and reliability by test-retest. 59 midwives were chosen by quota sampling and participated in a one-day workshop. Pretest and post-test questioner completed before and after four months of education by all midwives. Data analyzed by descriptive and inferencing statistical methods with SPSS.

Results: The paired t-test results showed that midwives practice about pain relieving methods changed significantly after workshop (p<0.005). Analytical methods demonstrated that there was no significant difference between mean practice scores and demographic characteristics of midwives. Conclusion: This study showed that teaching through workshop can improve the use of pain-relieving methods by midwives in labor wards especially more simple and efficacious methods.

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Background & Aim: Pain is the most common compliant of the patients and its reduction or elimination had been always demand of most patients and health care providers. Various methods have been proposed to pain, which we can mention to attention deviation strategies. The study aims to compare these strategies and choose the most effective one method for control the pain.

Methods & Materials: The research is a quasi-experimental one by which 230 students of one of the universities of Tehran were called out and participated in the test of tolerance to cold pressure induced pain. 120 participants that their tolerance were a point of standard deviation lower than the whole group were selected and were randomly set in 4 groups (3 experimental groups and 1 control group). These groups composed of 30 people were instructed a method of attention deviation (like desirable imagery, application of concentration point, counting down). The participation’s in control and experimental groups were tested by cold pressure and data were analyzed by SPSS through descriptive indices and One-Way Analysis of Variance (ANOVA).

Results: Results show that the average score of pain toleration in experimental groups were significantly higher than control group (p<.001). Meanwhile the average point of pain toleration in desirable imagery group were significantly higher than the average point of application of concentration point, counting down groups (p<.001).

Conclusion: The attention deviation strategies were effective in increasing of the experimental pain toleration.

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Background & Aim: Pain is one of the important complication of chronic diseases such as cancer. Purpose of this study is to investigation of two non-pharmacological methods, progressive muscle relaxation and music, on pain relief in patients suffer from cancer.

Methods & Materials: This research is a intervention clinical trial which was done in a hospital affiliated to Tehran University of Medical Sciences. In this study, 100 cancerous patients that have inclusion criteria were selected by simple sampling method. The participants into two groups allocated, 50 patients in progressive muscle relaxation, and 50 patients in music group. Data collection tools were questionnaire, pain level recorded sheet, taps with headphone (is produced by Sony company) and music box including light music consist of classical, mild and Iranian traditional music. Questionnaire was designed in two parts, demographically characteristics and disease characteristics. Data were collected by interview and patient self report. After adequate education to two groups, asked them to perform that method 30minet per day until 3 days. Then, pain level, at previous 24 hours until 3 days were assessed and recorded in related sheet. Analysis of data were analyzed by SPSS software, inferential and descriptive statistics such as Mann Whitney, chi Square, Fisher’s exact test, and Friedman.

Results: The finding of research showed in both relaxation and music groups there were significant differences in pain level before and after intervention (p<.001). Also there were significant differences between two groups in pain level (p=0.016). It means that pain relief in relaxation group was more significant.

Conclusion: According to the findings of this research, although both progressive muscle relaxation and music are effective and decreasing of pain level but progressive muscle relaxation is more effective than music.

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Background & Aim: Labor pain is regarded as one of the most intolerable pains which women experience during their life. Although there are many alternatives which can effect on person&aposs response and perception to pain and suffering, the pain is felt especially more severely and longer by primogeniture. Annually thousands of selective cesarean operations are performed just because of delivery pain frightening as the main reason. The pain can produce diverse and unwanted effects on delivery procedure and mother-fetus condition. So finding a method to relieve the pain and suffering is one the policies intently considered by health care systems. The aim of present study is to determine the effect of Entonox on implication of painless labor and woman&aposs satisfaction in a Hospital in Orumieh in 1385.

Methods & Materials: This research is a single blind clinical trail. Samples were consisted of women (160 persons), in two groups (each group 80 persons), which selected randomly. The intervention group used Entonox and the control group inhaled Oxygen. All subjects were instructed to use Visual Analogue Scale (VAS) and to inhale gases correctly. Due to emergency need for caesarean operation 2 members of the intervention group and 3 ones from the control group leaved the study. Data gathering tool were consisted of data registration form, VAS scale, mother vital sign recorder, and fetus heart rate recorder. The data were analysed using descriptive (relative & absolute frequencies, mean, and standard deviation) and inferential statistics (t-test, Mann-Whitney U, Chi-squared, Kolmogrove-Smirnov test) by SPSS computer software.

Results: According to the findings pain severity rate among the intervention group significantly was lower than the control group in the different hours of delivery procedure (P<0.001). Using Entonox made no effect on mother&aposs vital signs, labor process, fetus heart rate, first and fifth minute Apgar and bleeding rate after delivery. Also it was shown that probable side effects of Entonox inhalation such as drowsiness and mouth stiffness were more common in the intervention group (P<0.001), but no significant difference was seen in other complications. Meanwhile delivery satisfaction rate was higher in the intervention members.

Conclusion: It seems that Entonox inhalation might come in useful as an effective and safe method to alleviate labor pain and suffering along side with fewer likely risks for fetus and mother in clinical centers.

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Background & Objective: Labor pain is usually the most severe pain women experience in their lives. Most women suffer from low back pain during first stage of labor. The pain can produce adverse effects on delivery procedure. Because of potential side effects of medications used in labor, alternative methods for pain relief have received more attention nowadays. The aim of this study was to evaluate the effect of subcutaneous injection of sterile water on labor pain, type of labor, and satisfaction with pain management in nulliparous women.
Methods & Materials: This was a randomized single-blind study. Samples were consisted of 80 women who were randomly allocated to two intervention and control groups. In the intervention group (40 women) sterile water was injected subcutaneously in four sacral regions during first stage of labor. In the control group, we just inserted a needle in the same area. Low back pain intensity was assessed before and 10, 45, and 90 minutes after the injections using visual scales in both groups. Data were analyzed using descriptive (relative & absolute frequencies, mean and standard deviation) and inferential statistics (t-test, paired t-test and c²) in the SPSS.
Results: There was no significant difference between two groups at baseline. The mean of pain intensity in 10 and 45 minutes after the injection was decreased significantly in the intervention group (P=0.00). There was no significant difference between two groups in the 90^th minute. There was no difference in the type of labor between two groups. The mean of the satisfaction score was higher in the intervention group than in the control one.
Conclusion: It seems that subcutaneous sacral injection of sterile water might be an effective and safe method to alleviate labor pain in women

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Background & Objective: Illness, hospitalization and pain are often first crisis children faced with in their early life. Performing painful procedures such as IV injections for medical purposes are inevitable and stressful events in pediatric wards. Distraction is an inexpensive, practical, and nonpharmacological nursing intervention for pain relief. This study aimed to determine the effects of distraction on some physiological indices (heart rate and O₂ saturation (and intensity of pain in the hospitalized children aged 3-6 years undergoing IV injection.

Methods & Materials: In this clinical trial, 72 children aged 3-6 years who were undergoing IV insertion were recruited for the study. The participants were randomly allocated into two groups of intervention and control. Distraction technique was applied using bubble-maker in the intervention group. After 10 minutes, pain intensity was measured using OUCHER scale. Moreover, heart rate and blood oxygen saturation were measured for three minutes in both groups using Pulse Oxymeter pre- and post-intervention.

Results: The findings showed statistically significant differences in the average heart rate (P<0.01) and the amount of saturated oxygen (P<0.009) and the pain intensity (P<0.001) between two groups after the intervention. The pain decreased significantly in the intervention group in comparison with the control group.

Conclusion: According to the research findings, distraction with bubble-maker resulted in decreasing the physiological responses and intensity of pain in children aged 3- 6 years. This method can be useful in reliving the pain in preschool children undergoing IV insertion.

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Background & Objective: Labor pain management is one of the most important procedures of midwifery cares. Acupressure, a non-pharmacological method of labor pain relief, is an available, easy to use, inexpensive, and without side effect method of pain relief. The purpose of this study was to compare the effects of LI-4 acupressure on labor pain in women during first stage of labor.

Methods & Materials: A single blind randomized clinical trial study was carried out on 83 primipara women. The inclusion criteria were singleton pregnancy in 38-42 weeks of gestation, cephalic presentation, and spontaneous uterine contractions. Participants were divided into three groups including acupressure group, touch group, and the usual care (control group). The intensity of labor pain was measured using visual analog scale with the rating from 0-100 mm immediately, 30 minutes, and one hour after the intervention during the first stage of labor. Data were analyzed using statistical tests of ANOVA, Chi-square, and Exact chi-square.

Results: Findings indicated that acupressure group had lower labor pain in the active phase of the first stage of labor immediately after intervention than the other groups (P=0.026).

Conclusion: The results of this study suggested that LI4 acupressure reduced the intensity of labor pain in the first stage of labor without any side effects to mother and infant. This procedure can be used as a simple, safe and inexpensive method to relief labor pain.

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Background & Aim: The aim of this study was to investigate the relationship between nurses&apos knowledge about pain and satisfaction from pain relieving procedures among postoperative CABG patients in selected Tehran medical university hospitals.

Methods & Materials: In this cross-sectional study, 100 nurses were recruited from the ICU Open heart. Also, 200 patients were selected from whom underwent CABG in 24 hours after surgery and were extubated using a simple random sampling method. Data were gathered using two questionnaires including 17 question about demographic characteristics of patients and their satisfaction, and 36 questions about demographic characteristics and nurses&apos knowledge about pain and pain control after the CABG. Data were analyzed using descriptive and inferential methods using SPSS-11.5.

Results: There was not significant relationship between the nurses&apos pain knowledge and the patients&apos satisfaction. However, there were a significant relationship between the knowledge of the nurses about pain control after the CABG and the patients satisfactions (r=0.209, P=0.037).

Conclusion: According to the findings of the study, there were some significant relationships between the nurses demographic and pain knowledge with the pain control after the CABG. There was also significant relationship between patients&apos satisfaction and some of them demographic characteristics.

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Background & Aim: Pain can detrimentally affect physical functioning, psychological well-being and social interaction. Various attitudinal factors may be associated with inadequate pain control. Hence, studies should be undertaken to gain a better understanding of association between pain control attitudes and use of analgesics and cancer pain intensity. This study aimed to determine relationship between pain control attitudes and use of analgesics and pain intensity in cancer patients with pain.

Methods & Materials: A descriptive cross-sectional study was conducted with 200 cancer patients who underwent chemotherapy or radiotherapy and experienced pain in previous 24 hours. The pain control attitudes, use of analgesics, worrisome about using analgesics and physical and psychological impacts of pain were measured using questionnaires. The cancer pain intensity was measured using the visual analogue scale. Validity and reliability of the instruments were evaluated. Data were analyzed using independent t-test and ANOVA.

Results: About 58% of patients agreed that they would wait before asking for help. Beside, the findings indicated that willing to tolerate pain and perceived control over pain were associated with the time and frequency of taking analgesic and pain intensity in previous 24 hours and last week. Also concerns about addiction to pain-relieving medications were related to the analgesic type and pain intensity within last week (P=0.03), and fear of injection was related to analgesic use and pain intensity within last week (P<0.001).

Conclusion: Many cancer patients had attitudes which could interfere with pain relieving. Suggestions are made for developing patient education programs, accessing effective cancer pain controls and decision making for cancer pain relief.

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Background & Aim: Shoulder pain is a consequence of hemiplegia among patients with stroke. It makes patient to be dependent to others in their daily living activities. This study aimed to determine the effect of the slow stroke back massage (SSBM) on shoulder pain and hand function among patients with stroke.

Methods & Materials: In this semi-experimental study, 34 patients were recruited among from 70 patients who reffered to rehabilitation center in 2010, according to the inclusion criteria. Participants were randomly allocated into two groups of control and experiment. In the intervention group, the SSBM was implemented for 10 minutes through seven consecutive sessions. Shoulder pain and hand function were measured using the visual pain scale (Visual Analog Scale), and the researcher-made "affected hand function in ADL" instrument, respectively. The measurement was done before and 24 hours after the last session of the intervention. Data were analyzed using descriptive and inferential statistical tests (independent t-test and paired t-test).

Results: At baseline, the mean scores of shoulder pain were 8.4 in both experimental and control groups (P=0.999). After the intervention, the mean scores of shoulder pain were 1.13 and 8.40 in experimental and control groups, respectively (P<0.001). At baseline, the mean scores of hand function were 7.46 and 8.93 in the experimental and control groups, respectively (P=0.752). After the intervention, the mean scores of hand function reached 9.13 and 8.6 in the experimental and control groups, respectively (P=0.918).

Conclusion: According to the results of the study, applying the SSBM as a treatment procedure and care plan by health care providers can be considered as an effective intervention to prevent or reduce shoulder pain and consequently to improve motor function of affected hand in patients with hemiplegia after stroke.

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Background & Aim: Premature infants undergo painful and stressful procedures during care and treatment. Nurses can help to reduce short- and long-term effects of pain caused by diagnostic and therapeutic procedures using various methods including music therapy. The aim of this study was to assess the effect of music therapy on physiological pain responses of premature infants during and after blood sampling.

Methods & Materials: This was an experimental study with crossover design conducted on 20 premature infants hospitalized in the intensive care unit of a hospital affiliated to the Tehran University of Medical Sciences for a five months period in 2010-11. Infants were randomly allocated in two groups of experiment and/or control. Each infant was considered as its own control. We assessed the physiological pain responses caused by blood sampling such as heart rate and oxygen saturation level. Infants in the experiment group listened to the Transitions music five minutes before until 10 minutes after the blood sampling. The responses were recorded and reviewed ten minutes before until ten minutes after the blood sampling in both groups and physiological changes were detected. Data were analyzed using ANOVA and Chi-square tests in the SAS and SPSS.

Results: Results showed significant difference in heart rate between the experiment and control groups during needle exit (P=0.022). There was also significant difference in heart rate between experiment and control group in the first 5 minutes of blood sampling (P=0.005).

Conclusion: Results showed that music therapy could reduce some physiological responses of pain during and after blood sampling. Music therapy can be used as a beneficial intervention following painful procedures such as blood sampling in the NICU.

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Background & Aim: The presence of pain is a common phenomenon among patients in critical care units. Critically ill patients are often unable to communicate because of illness or sedation so, recognition and assessment of their pain is difficult. In these patients, observational behavioral indices can be used to evaluate pain. The aim of this study was to investigate the effect of application of critical-care pain observation tool in patients with decreased level of consciousness on performance of nurses in documentation and reassessment of pain after palliative intervention.

Methods & Materials: In this before and after quasi-experimental study, 106 nurses working in general intensive care units in selected hospitals affiliated to Tehran University of Medical Sciences were selected. First, we examined the nurses&apos performance three times in relation to documentation and reassessment of pain after palliative intervention, position change and suction procedure in patients with decreased level of consciousness using a researcher-made check list. Then, we taught nurses individually, how to use this tool to investigate the pain of patient in a session lasting an hour. A week after the training, the researcher reevaluated performance of trained nurses in relation to documentation and reassessment of pain after palliative intervention in patients with decreased level of consciousness. Finally, those data collected before and after the training of the CPOT to nurses were compared using the Wilcoxon test.

Results: Findings showed that the CPOT could not lead to improved nurses&apos function in relation to documentation of pain in the patients records (P=0.209) and recording palliative measures related to pain (P=0.117). However, there were significant statistical differences between nurses&apos function in relation to reassessment of pain after palliative intervention, before and after the training and application of the CPOT. Comparing the mean function scores before and after the intervention, demonstrated that the performance of nurses in this area has been improved after the intervention.

Conclusion: The critical-care pain observation tool can increase nurses&apos sensitivity to pain in patients with decreased level of consciousness. It forces the nurses to reassess the pain after palliative intervention. This tool does not motivate in nurses to document pain palliative process. So it is recommended that future studies investigate the impact of this tool on other aspects of pain management, such as diagnosis of pain and using of drugs and non-drug measures.

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Background & Aim: Pain is an unpleasant experience related to potential or actual tissue damage. Distraction is an effective technique to control pain. This study aimed to examine the effect of pressing a small soft ball during intravenous catheter insertion on pain related behavioral responses of children.

Methods & Materials: A randomized clinical trial study was conducted in surgical ward of the Qods hospital in Qazvin, Iran in 2010. Sixty children aged 4-6 were selected through a simple randomized sampling method. The children were allocated into two equal intervention and control groups. Data were collected using the FLACC scale. In the intervention group, children were asked to press a soft ball during IV catheter insertion. The researcher marked the FLACC during the procedure. In the control group, no distraction was made during the IV catheter placement. The data were analyzed using descriptive statistics, independent-sample t-test, Chi square at P<0.05.

Results: There was no significant difference between the two groups in terms of demographic variables including gender, birth order, race, age and type of disease. In the intervention group, none of the children experienced severe pain during IV catheter insertion and 63.3% of the children had moderate pain. In the control group, 50.0% of children had moderate pain and 23.3% of them experienced severe pain during IV catheter insertion. There was a significant difference in perceived pain between the children of two groups (P<0.001).

Conclusion: Distraction is an effective, non-expensive, and easy-to-access technique to control and reduce pain in children during IV catheter placement. This study showed that distraction through pressing a soft ball was effective in reducing the behavioral responses of pain in children who underwent IV catheter placement.

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  Background & Aim: Patients with end-stage renal disease undergoing hemodialysis are repeatedly exposed to stress and pain from approximately 300 punctures per year to their arteriovenous fistula . Patient comfort with the procedure is therefore of greatest importance for long-term compliance with the treatment and until a successful renal transplant. This study was conducted to determine the effect of rhythmic breathing on pain intensity when the needles are inserted into vascular access for hemodialysis .

  Methods & Materials: This was a quasi -experimental one-group time-series study. Thirty five patients in hemodialysis ward of Hamadan Besat hospital entered into the study via convenient sampling method. In this study, pain intensity during the insertion of hemodialysis vascular needles was measured in six sessions through two methods of routine intervention and rhythmic breathing. The data were collected using visual analog scale. Paired t-test was used to determine pain intensity mean difference between the two conditions . 

  Results: Overall, the results showed that the mean pain intensities were 5.45±1.15 and 2.19±0.92 in two conditions including routine intervention and rhythmic breathing , respectively. Paired t-test showed a significant difference between the routine intervention and rhythmic breathing (P<0.001) .

  Conclusion: These findings showed that rhythmic breathing was effective in reducing pain when the needles were inserted into the vascular access. Therefore, it is recommended to use rhythmic breathing as a simple and non-expensive method to reduce pain in patients before insertion of hemodialysis vascular needles .

  

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  Background & Aim: Patients with multiple sclerosis suffer from permanent pain. It is being increased to apply relaxation therapy to decrease patients' pain. The progressive muscle relaxation make the muscles feel more relaxed. The aim of this study was to assess the effect of progressive muscle relaxation on pain among patients with multiple sclerosis .

  Methods & Materials: A randomized controlled trial was carried out among 70 patients with multiple sclerosis selected from Hamadan Multiple Sclerosis Society patients. Inclusion criteria involved diagnosed with multiple sclerosis, 20-65 year old patients, having ability to do daily 20-minute exercises, feeling pain, having an EDSS score equal or less than 4.5. Patients were randomly divided into two groups of control and intervention. Patients' pain was measured using the VAS scale in the two groups at baseline. The relaxation training was implemented among intervention group patients and was repeated three times a week for four weeks. Each session lasted 40 minutes and the patients continued doing exercise at home for the other eight weeks. The control group patients were observed routinely. Patients' pain was measured eight weeks later in both groups. Data were analyzed using the paired independent t-test in the SPSS-16 .

  Results: Muscle relaxation had significant effect on pain among patients with multiple sclerosis (P<0.05). The mean of pain severity decreased from 4.60 ± 1.75 to 3.26±1.88 in the intervention group after the intervention. The mean of pain severity remained constant .

  Conclusion: This progressive muscle relaxation can be used for decreasing pain among patients with multiple sclerosis as a non-expensive, safe and simple method .