Chronic pain is the most common health problem treated with complementary and alternative medicine (CAM) therapies in the United States. In the past decade, strong evidence has been accumulated regarding the benefits of mind-body therapies, acupuncture, and some nutritional supplements. Other CAM therapies such as massage, chiropractic therapies, therapeutic touch, certain herbal therapies, and dietary approaches have the potential to alleviate pain in some cases. However, the evidence supporting these therapies is less concrete.
Some people use other kinds of CAM to alleviate pain in spite of the fact that the effectiveness and safety of some of these treatments have not been evaluated by large, well-controlled trials. Always consult a doctor before using any CAM.
Mind-body therapies
Mind-body therapies (MBT) are treatments that are meant to help the mind’s ability to affect the functions and symptoms of the body. MBT can involve various approaches including relaxation techniques, meditation, guided imagery, biofeedback, and hypnosis. Available data do not indicate that one mind-body technique is more effective than another for a given condition.
Research has shown that relaxation techniques can help alleviate discomfort related to certain conditions and situations, including:
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Chronic pain
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Cancer
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Headaches
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Post-heart attack care
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Pre-surgical preparation
MBT used for treatment of chronic pain conditions appear to be cost-effective and to result in minimal adverse effects. However, people who decide to employ MBT for the treatment of chronic pain should do so under the guidance of appropriate health care professionals.
Manual CAM treatments: chiropractic treatment and massage
Chiropractic treatment is the most common non-surgical treatment for back pain. Improvements of people undergoing chiropractic manipulations were noted in some trials. However, the treatment’s effectiveness in treating back and neck pain has not been supported by compelling evidence from the majority of randomized clinical trials. Further studies are currently in progress focusing on the role of this promising approach to pain management.
Massage is being increasingly used by people suffering from pain, mostly to manage chronic back and neck problems. Massage can reduce stress and relieve tension by enhancing blood flow. This treatment also can reduce the presence of substances that might generate and sustain pain. Available data suggest that massage therapy, like chiropractic manipulations, holds considerable promise for managing back pain. However, it is not possible to draw final conclusions because of methodological shortcomings of conducted randomized trials.
Therapeutic touch and reiki healing
Therapeutic touch and reiki healing are thought to help activate the self-healing processes of an individual and therefore reduce pain. Although these so called "energy-based" techniques do not require actual physical contact, they do involve close physical proximity between practitioner and patient. Over the past few years, several reviews evaluated published studies on the efficacy of these healing approaches to ease pain and anxiety, and improve health. Although beneficial effects with no significant adverse side effects were reported in several double-blind studies, the methodological limitations of some of these studies make it difficult to draw definitive conclusions. Further studies are needed before the evidence-based recommendation for using these approaches for pain treatment can be made.
Herbal remedies
It has been difficult to draw conclusions about the effectiveness of herbs. If you decide to use herbal preparations to better manage your pain, it is of critical importance to share this information with your health care professional. Some herbs might interact with drugs you are receiving for pain or other conditions, and might harm your health.
Nutritional supplements
There is solid evidence of the effectiveness of glucosamine sulfate and chondroitin sulfate in patients with knee osteoarthritis. These natural compounds were found to decrease pain and increase mobility of the knee, and were well-tolerated and safe. Whether glucosamine can slow radiologic progression of osteoarthritis remains to be demonstrated in future studies.
Dietary approaches
Some people believe that changing dietary fat intake and/or consuming plant foods that contain anti-inflammatory agents can help ease pain by limiting inflammation. A mostly raw vegetarian diet was found helpful for some people with fibromyalgia, but this study was not randomized and was without a control group. One study of women with premenstrual symptoms suggested that a low-fat vegetarian diet was associated with decreased pain intensity and duration. Weight loss achieved by a combination of dietary changes and increased physical activity was shown to be helpful for people suffering from osteoarthritis. Further research is likely concerning the use of dietary approaches in treating patients with chronic pain conditions.
Acupuncture
Although the World Health Organization currently recognizes almost 30 diseases or conditions that can be helped by acupuncture treatment, one of the main uses of acupuncture is for pain relief. For other conditions — including headache, low back pain, menstrual cramps, carpal tunnel syndrome, tennis elbow, fibromyalgia, osteoarthritis, and myofascial pain — acupuncture might be useful as an accompanying treatment to traditional methods. Acupuncture also might be an acceptable alternative to or might be included as part of a comprehensive pain management program.
Things to keep in mind when using CAM
Work closely with your health care professional when examining possible options for pain treatment and ways to improve your lifestyle. Also, surround yourself with people who will support you in your efforts. Recent research shows that social rejection activates areas of the brain that are turned on by physical pain. Strong social support and high doses of loving feelings might be the key ingredients for successful pain management.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/16/2004
