Relief from chronic pain may be what first sends us off in search of alternative or complementary medicine, but once we get there, the possibilities and promises are all but endless. And it is here that we need to keep our wits about us.
Yes, indeed, it would be lovely if a handful of herbs and a dash of tai chi solved all of our medical challenges. They won’t. But there are CAM therapies that are very effective, especially when used in conjunction more conventional treatments. Try to keep an open mind and avoid black and white thinking: Western medicine is not the enemy, nor are all lifestyle approaches either miracles or marginal. Healing is an art and a science, too. We need to do our part and accept responsibility for our choices and their potential consequences. We need to accept responsibility for our own health and fitness. We may have to be creative, here, and use massage and healthy eating along with the prescription written by the doctor to overcome an injury. Consider how very lucky this makes us. We have options. We have support. We have hope.
Should you be considering CAM for chronic pain, the most common condition for which adults use alternative treatments, keep in mind the following:
- Do not postpone seeing a physician about chronic pain or any other medical problem because you are considering CAM. Nor should you use CAM therapy as a replacement for conventional care unless your doctor specifically approves that approach.
- Learn all you can about the treatment you are considering. Focus particularly on whether there is any scientific evidence on its efficacy and safety.
- Talk with all your health care providers about the chronic pain. Tell them about the therapy you are considering. Find out what they know about it. They may be able to advise you as to its safety and potential effectiveness.
- Considering a practitioner-approved CAM therapy such as massage, acupuncture or chiropractic manipulation? Ask a trusted source – your doctor, the nearby hospital – to recommend a practitioner. Learn all you can about his or her experience, training and standing in the medical community. Find out if that practice has any experience with your pain condition.
- Co-ordinate your care. Let all your health care providers know about the CAM therapies you are using. This will help ensure safe and coherent care. Let them know everything you do to manage your own health.
- If you are taking dietary supplements, keep in mind that they need to be used correctly. Vitamins and other supplements can interact with your prescription medications, even your non-prescription medications. Follow the recommendations of your health care provider on their safe use. If you are pregnant or nursing a child, be extra careful about consulting your doctor.
CAM and common kinds of pain
Clinical practice guidelines issued by the American College of Physicians/American Pain Society in 2007 recommended three therapies – acupuncture, massage and spinal manipulation
– for the relief of chronic low-back pain as there is evidence that these therapies may be beneficial. Five other nonpharmacologic (nondrug) approaches for patients whose back pain was not relieved with medication, education and self-care were also recommended: progressive relaxation, exercise therapy, cognitive-behavioral therapy, intensive interdisciplinary rehabilitation
Reviews of research on other CAM therapies that are suggested or used for the relief of chronic low-back pain, such as herbal remedies
and prolotherapy injections, tell another story. There is very limited evidence, mixed evidence, or no evidence, to support their use for the relief of this kind of pain.
treatments and approaches that have been studied for the relief of osteoarthritis pain include herbal remedies, mineral baths, tai chi, glucosamine/chondroitin and acupuncture.
Many of these therapies have also been studied for their relief of rheumatoid arthritis symptoms. There is much promise in some of the studies, but the hard evidence is mostly limited or mixed.
Acupuncture has been shown to lead to small improvements in pain and function. Large clinical trials indicate that glucosamine and chondroitin sulfate, while very popular dietary supplements, did not significantly relieve knee osteoarthritis pain in all participants; a combination of the two did help a subgroup in the trial with moderate-to-severe pain. Gamma linolenic acid (GLA, from evening primrose and certain other plant oils) may relieve rheumatoid arthritis pain, though much more research is needed; certain dietary supplements known as ASUs (avocado-soybean unsaponifiables) and devil’s claw may provide some relief from osteoarthritis pain.
Systematic reviews of research on acupuncture
indicate that it may be effective for reducing the intensity and frequency of migraine and tension headaches (for patients who benefit from acupuncture therapy
Spinal manipulation may help patients with chronic tension headaches or neck-related headaches.
Neck pain. Here, additional research and trials are needed. Evidence supporting the use of acupuncture and manual therapies (mostly manipulation or mobilization) is mixed. And there is no overall consensus on the status of these therapies, even while clinical guidelines often endorse the use of manual therapies for neck pain.
Other types of pain.
There have been studies of CAM
approaches for various other types of chronic pain – facial pain, TMJ, cancer pain, nerve pain and fibromyalgia and so on. In general, there is certainly plenty of promising evidence of effectiveness but more research is needed before treatment recommendations can be confidently made.
Next: more about CAM research; other conditions treated with CAM; finding a practitioner; keeping track of results.