Complementary Health Approaches for Chronic Pain
by Dr. Thomas K. Lo, Advanced Chiropractic & Nutritional Healing Center
A growing body of evidence suggests that some complementary approaches, such as acupuncture, hypnosis, massage, mindfulness meditation, spinal manipulation, chiropractic, tai chi, and yoga, may help to manage some painful conditions.
What is the Safety of Complementary Health Approaches for Chronic Pain?
Although the mind and body practices studied for chronic pain have a good safety record, that does not mean that they are risk-free for everyone. Your health and special circumstances (such as pregnancy) may affect the safety of these approaches. If you are considering natural products, remember that natural does not always mean safe and that some natural products may have side effects or interact with medications you may be taking.
What Is Chronic Pain and Why Is It Important?
Chronic pain is pain that lasts for more than several months (defined as three to six months, or as longer than “normal healing”). It is a very common problem. Results from a National Health Interview Survey showed that about 25.3 million U.S. adults (11.2 percent) had pain every day for the previous three months. In addition, nearly 40 million adults (17.6 percent) had severe pain.
Individuals with severe pain had worse health, used more health care, and had more disability than those with less severe pain.
Who Has Chronic Pain?
Chronic pain becomes more common as we age, at least in part because health problems that can cause pain, such as osteoarthritis, become more common with advancing age. Military veterans are another group at increased risk for chronic pain; U.S. national survey data show that both pain, in general, and severe pain is more common among veterans than in nonveterans.
Not all people with chronic pain have a health problem diagnosed by a health care provider, but among those who do, the most frequent conditions, by far, are low-back pain or osteoarthritis, according to a national survey.
Other common diagnoses include rheumatoid arthritis, migraine, carpal tunnel syndrome, and fibromyalgia.
The annual economic cost of chronic pain in the United States, including both treatment and lost productivity, has been estimated at up to $635 billion.
Chronic pain may result from an underlying disease or health condition, an injury, medical treatment (such as surgery), inflammation, or a problem in the nervous system, or the cause may be unknown. Pain can affect quality of life and productivity, and it may be accompanied by difficulty in moving around, disturbed sleep, anxiety, depression, and other problems.
What the Science Says About Complementary Health Approaches for Chronic Pain
The scientific evidence suggests that some complementary health approaches may help people manage chronic pain.
I will highlight the research of some approaches used for common kinds of pain.
Chronic Pain Complementary Approaches
There is evidence that acupuncture, yoga, relaxation techniques, tai chi, massage, and osteopathic or spinal manipulation may have some benefit for chronic pain.
Research also shows that hypnosis is moderately effective in managing chronic pain, when compared to usual medical care. However, the effectiveness of hypnosis can vary from one person to another. A study of mindfulness meditation for chronic pain also showed to be associated with an improvement in pain symptoms.
Also, studies on music have shown that it can reduce self-reported pain and depression symptoms in people with chronic pain.
Low-Back Pain
Low-back pain has shown improvement with acupuncture, and a massage therapist might provide short-term relief from low-back pain. Unfortunately, massage has not been shown to have long-term benefits for low-back pain.
A research review concluded that mindfulness-based stress reduction is associated with improvements in pain intensity and physical functioning in low-back pain, compared to usual care.
Spinal manipulation appears to be as effective as other therapies commonly used for chronic low-back pain, such as physical therapy, exercise, and chiropractic.
An evaluation of the research on yoga for low-back pain found that it improved pain and function in both the short term (1-6 months) and intermediate term (6-12 months). Yoga is an option for chronic, but not acute, low-back pain.
A study on herbal products for low-back pain found evidence that cayenne, administered topically (applied to the skin) can reduce pain. Two other herbal products used topically, comfrey and lavender essential oil, and two herbs used orally, white willow bark and devil’s claw, may also be helpful, but the evidence for these herbs is not as strong as that for cayenne.
Osteoarthritis
There is evidence that acupuncture has short-term benefits in relieving knee pain caused by osteoarthritis.
A study for osteoarthritis of the knee concluded that tai chi has short-term (up to 12 weeks) and medium-term (12-26 weeks) benefits on pain for people with knee osteoarthritis. There has not been enough research to show whether it is helpful for longer periods.
Studies of glucosamine, chondroitin, and S-adenosyl-L-methionine (SAMe) for knee osteoarthritis pain may be effective for some.
Rheumatoid Arthritis
Dietary supplements containing omega-3 fatty acids, gamma-linolenic acid (GLA), or the herb thunder god vine may help relieve rheumatoid arthritis symptoms.
Headaches
There is moderate evidence that acupuncture may reduce the frequency of migraines.
Guidelines from the American Academy of Neurology and the American Headache Society classify butterbur as effective; feverfew, magnesium, and riboflavin as probably effective; and coenzyme Q10 as possibly effective for preventing migraines.
Neck Pain
Studies on acupuncture suggest that acupuncture is helpful for neck pain.
Massage therapy may provide short-term relief from neck pain, especially if massage sessions are relatively lengthy and frequent, but it does not appear to be more effective than other therapies.
Spinal manipulation also may be helpful for relief of neck pain.
Fibromyalgia
Some studies show tai chi, yoga, mindfulness, and biofeedback for fibromyalgia symptoms have had promising results.
In addition, vitamin D supplements, for those who have low vitamin D levels, may help to reduce pain in people with fibromyalgia.
Irritable Bowel Syndrome
Probiotics may be helpful for irritable bowel syndrome, but it is still uncertain which types of probiotics are most effective.
Some formulations of peppermint oil may be helpful for irritable bowel symptoms as well.
Other Types of Pain
Various complementary approaches have been studied for other types of chronic pain, such as nerve pain, chronic pelvic pain, and pain associated with endometriosis, carpal tunnel syndrome, pain associated with gout, and cancer. There is promising evidence that the complementary approaches talked about earlier in this article may be helpful for some of these types of pain.
What the Science Says About Safety and Side Effects
As with any treatment, it is important to consider safety before using complementary health approaches. Safety depends on the specific approach and on the health of the person using it. If you are considering or using a complementary approach for pain, check with your health care provider to make sure it is safe for you.
Safety of Mind and Body Approaches
Mind and body practices, such as acupuncture, hypnosis, massage therapy, mindfulness/meditation, relaxation techniques, spinal manipulation, tai chi/qi gong, and yoga, are generally safe for healthy people if they are performed appropriately. People with medical conditions and pregnant women may need to modify or avoid some mind and body practices.
Like other forms of exercise, mind and body practices that involve movement, such as tai chi and yoga, can cause sore muscles and may involve some risk of injury.
Safety of Natural Products
Remember “natural” does not always mean “safe.” Some natural products may have side effects and may interact with medications.
Millions of people in the United States are living with some form of chronic pain daily. Chronic pain can seriously interfere with your daily activities, work, studies, family life, social life, and emotional well-being.
If you are struggling with health issues, call the Advanced Chiropractic & Nutritional Healing Center at 240-651-1650 for a free consultation. Dr. Lo uses Nutritional Response Testing® to analyze the body to determine the underlying causes of ill or non-optimum health. The office is located at 7310 Grove Road #107 in Frederick. Check out the website at www.doctorlo.com.
