Complementary health procedures – the so-called “alt-health” practices of acupuncture, tai chi, yoga, massage therapy, and relaxation techniques – are a $30 billion a year business. Although people in pain have embraced them whole-heartedly, the Western medical establishment has been notedly slow to cotton up to them. That may all change now, following a review of U.S.-based clinical trials by the National Center for Complementary and Integrative Health (NCCIH) and published in Mayo Clinic Proceedings that suggests these procedures appear to be effective tools for helping to manage common pain conditions.
“For many Americans who suffer from chronic pain, medications may not completely relieve pain and can produce unwanted side effects. As a result, many people may turn to non-drug approaches to help manage their pain,” said Richard L. Nahin, PhD, NCCIH’s lead epidemiologist and lead author of the analysis. “Our goal for this study was to provide relevant, high-quality information for primary care providers and for patients who suffer from chronic pain.”
The scientists carved out back pain, osteoarthritis, neck pain, fibromyalgia, and severe headaches and migraine for their research. They then pored over 50 years and 105 randomized controlled trials worth of data. A therapy's effectiveness was validated if it led to statistically significant improvements in pain severity, pain-related disability, and/or function. If the scientists could find no difference between the alternative therapy group and the control group, the therapy was determined to be invalid for that ailment.
What they found was that there was no panacea – no one alternative, or “complementary,” therapy worked for all the ailments for which they were filtering data. But they did validate the following therapy/pain combinations:
- Acupuncture and yoga for back pain
- Acupuncture and tai chi for osteoarthritis of the knee
- Massage therapy for neck pain with adequate doses and for short-term benefit
- Relaxation techniques for severe headaches and migraine.
Although the evidence was weaker than the four combos above, the researchers also found that massage therapy, spinal manipulation, and osteopathic manipulation had some traction for people with back pain, and that tai chi and relaxation therapy aided some people with fibromyalgia.
“These data can equip providers and patients with the information they need to have informed conversations regarding non-drug approaches for treatment of specific pain conditions,” said David Shurtleff, PhD, deputy director of NCCIH. “It’s important that continued research explore how these approaches actually work and whether these findings apply broadly in diverse clinical settings and patient populations.”