Last week, we started looking at CAM, complementary and alternative treatments and therapies. More and more Western physicians and healthcare professionals are looking into these therapies, adding them to the conventional arsenal, if you will, if science verifies their effectiveness. And there are more than a few promising candidates.
Millions of Americans endure living with pain that is severe, chronic and not easily managed. Acute pain is one thing, a perfectly normal sensation; chronic pain is something else altogether, persisting for weeks, months, even years. A national survey found that 26 percent (76.5 million Americans) reported pain that lasted more than 24 hours. Among those that reported pain, 46 percent indicated that it lasted for more than a year.
Chronic pain arises from an injury – neck or back sprain, for example – or is part of a disease or may have no evident cause. And there are other health problems often encountered with chronic pain, including sleep disturbances, mood changes, persistent fatigue and mobility limitations. Common conditions associated with chronic pain are low-back pain, arthritis pain, pain from nerve damage, cancer pain, headache and fibromyalgia. Related co-existing conditions include chronic fatigue syndrome, endometriosis, TMJ, interstitial cystitis and more. It is not yet confirmed whether or not these problems have a common cause.
Chronic pain is generally first treated in all the usual ways, with prescription and nonprescription medications. Sometimes these drugs do the trick, but more often than not, the medications have all sorts of unpleasant and even dangerous side effects and do not, in fact, provide adequate relief. Long-term use is not the solution. This is where other approaches come in: physical therapy, exercise, CAM therapies and cognitive behavioral therapy to name a few.
America’s number one reason for turning to CAM is to relieve chronic back pain, followed by neck pain, joint pain and stiffness and arthritis. Severe headache and other musculoskeletal pain were also among the top ten reasons for using alternatives along with more conventional treatments. And there are all sorts of approaches for those seeking help with chronic pain, including dietary supplements (glucosamine and chondroitin, along with herbs), massage, spinal manipulation, hypnotherapy, guided imagery, medication, relaxation therapy, yoga and acupuncture.
Now we come to the science part. What scientific evidence is there that any of these treatments really help?
First, the solid scientific evidence for many popular and widely used therapies is limited, growing, but limited. Here is what the National Center for Complementary and Alternative Medicine (NCCAM) has reported on this subject:
Scientific evidence on CAM therapies includes results from laboratory research (e.g., animal studies) as well as clinical trials (studies in people). It encompasses both ‘positive’ findings (evidence that a therapy may work) and ‘negative’ findings (evidence that it probably does not work or that it may be unsafe). Scientific journals publish study results, as well as review articles that evaluate the evidence as it accumulates; fact sheets from the National Center for Complementary and Alternative Medicine National Center (NCCAM) – like this one – base information about CAM research primarily on the most rigorous review articles, known as systematic reviews and meta-analyses. Authors of such reviews often conclude that more research and/or better designed studies are needed.
Before we explore each option in detail, let’s have a look at the scientific evidence on CAM for pain:
- Spinal manipulation
- Progressive relaxation
- Prolotherapy (nonsurgical ligament reconstruction)
- Herbal remedies
- Gamma Linolenic Acid (GLA)
- Herbal remedies
- Balneotherapy (mineral baths)
- Tai Chi