Alternative medicine and complementary therapy are no longer terms used solely by the granola-eating crowd. The search for alternatives to conventional medicine, especially within the realm of pain relief, has been gaining momentum. Whatever the reason from the health-threatening side effects of popular pain medicines like Vioxx , to a desire to use only natural remedies the chase is on for new therapies to alleviate the pain of chronic illness.
According to the American Pain Foundation, complementary and alternative medicine (CAM) is growing at a rate of 15% each year, with more than $24 billion spent on therapies outside conventional medicine. In large part because of this growth, the government established the National Center for Complementary and Alternative Medicine in 1991, an organization whose charge is to investigate promising unconventional medical practices.
It’s important to note that while complementary medicine and alternative medicine can often refer to the same types of treatment, they are employed differently. Complementary medicine refers to treatments that are combined with conventional medicine, while alternative medicine replaces conventional medicine.
Chronic pain pain lasting longer than six month can be brought on by many conditions, but the major contributors are arthritis, cancer, back pain, migraines, and neurogenic pain (nerve pain). Various CAM therapies have been used to alleviate pain, including acupuncture, magnet therapy, chiropractic therapy, local electrical stimulation, brain stimulation, relaxation therapy, certain herbs, hypnosis, and biofeedback.
Despite the fact that acupuncture is thousands of years old, only recently has its effectiveness in relieving pain been studied. Acupuncture works on the premise that the body is made up of twelve main meridians, or energy pathways, and that disease develops when there is an internal imbalance of the body’s energy. In acupuncture, hair-thin needles are inserted into the skin at specific areas to increase the flow of energy throughout the body.
In a recent study, researchers led by Jorge Vas from the Pain Treatment Unit in Dos Hermanas, Spain, analyzed the efficacy of acupuncture in treating osteoarthritis. Ninety-seven patients with osteoarthritis of the knee were randomly split into two groups. Half received acupuncture and diclofenac (a prescription NSAID), while the rest received diclofenac and placebo acupuncture. Placebo acupuncture was given by using retractable needles that didnâ€™t puncture the skin. The researchers found that acupuncture, as a complementary therapy, was more effective than just pharmacological treatment in reducing pain and rigidity, as well as improving physical functioning, in osteoarthritis sufferers.
In another, smaller study, Kenneth D. Phillips, PhD and colleagues studied the effect of acupuncture in relieving peripheral neuropathy pain in 21 HIV-infected individuals. Acupuncture was performed on the subjects a total of ten times over five weeks. The needles were inserted according to individual symptoms. The results showed significant reduction in pain, and reduced symptoms of peripheral neuropathy. The researchers concluded that acupuncture can successfully treat the symptoms of pain and neuropathy in HIV-infected individuals, and that further research is warranted.
Magnet therapy can be traced back to the third century A.D. when Greek physicians prescribed magnetized rings to treat arthritis. Theories about how magnets work range far and wide, yet research has not conclusively proven their efficacy. Still, the popularity of magnet therapy persists in the form of magnetic bracelets, shoe insoles, belts, and bandages, with one survey ranking it second in CAM therapies used by arthritis and fibromyalgia patients.
Scientific research has produced some promising, if not conclusive results. In a study led by Candace S. Brown, PharmD, 32 patients with chronic pelvic pain were given either active or placebo magnets attached to their abdomens. Changes in pain relief and disability were calculated using three pain measurement tools. The patients who received active magnets for four weeks experienced less pain. The researchers point out, however, that the active group was more likely to identify their treatment, affecting the blinding efficacy of the study.
In a study out of Harvard Medical School, researchers enrolled 29 patients with osteoarthritis of the knee to see if magnet therapy could relieve their pain. Subjects received a sleeve equipped with either an active or a placebo magnet initially to be worn for four hours in a hospital setting. Patients were also instructed to wear their sleeves for six hours a day for the next six weeks. In this study, the researchers found improvement in pain among the magnet-wearers at four hours, but the relief was not sustained at weeks one or six.
Chiropractic therapy is a hands-on therapy that uses manipulations to the spine to help the body function better. Neck and back pain are the most common reasons for chiropractor visits. While adjustments or manipulations are the major therapies used by chiropractors, other mediums such as heat and ice, ultrasound, electrical stimulation, magnetic therapy, and exercise may be used to supplement the treatment plan.
As for pain relief, back pain has been the most studied in terms of chiropractic therapy. In a randomized clinical trial conducted by Hurwitz et al, 652 patients with low-back pain received either conventional medical care or chiropractic care. At the end of six months, the researchers found that conventional medical care and chiropractic regimens were comparably effective in reducing pain intensity and disability.
Medicine, whether conventional, alternative, or complementary, is not an exact science. As our understanding of CAM therapies grows, so does our ability to employ additional alternatives to treating chronic pain. Perhaps a combination approach based on the individual patient will prove to be the most effective medicine. For now it is always wise to talk to your physician and decide together what’s best for you.
American Pain Foundation
American Pain Society
National Center for Complementary and Alternative Medicine