Results from a review of U.S.-based clinical trials indicate that some popular complementary health techniques — such as yoga, tai chi, and acupuncture — are effective in helping to manage common pain conditions, including fibromyalgia.
The review, titled “Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States,” was published in the journal Mayo Clinic Proceedings.
The most recent national estimate suggests that 126 million adults experience some pain in a given year, with about one-third having severe pain. Pain is often associated with poor general health, health-related disability, and increased healthcare utilization.
But pain is still routinely under-treated in healthcare and the pain care that is provided is often fragmented without a comprehensive assessment or treatment plan. Also, patients may find it difficult obtaining the full range of potential treatments.
Medications may provide only partial relief from chronic pain and can have unwanted side effects. As a result, many people turn to complementary and alternative health approaches as part of their pain management strategy. However, primary care providers have lacked the scientific evidence to guide recommendations for their patients.
The new review, conducted by a team of researchers from the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH), gives primary care providers the tools to help make decisions on how to help patients manage their pain.
“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 nondrug approaches to help manage their pain,” Richard L. Nahin, PhD, NCCIH’s lead epidemiologist and lead author of the study, said in a news release. “Our goal for this study was to provide relevant, high-quality information for primary care providers and for patients who suffer from chronic pain.”
In the review, 105 U.S.-based randomized controlled trials from the past 50 years were included. All studies assessed the effectiveness and safety of acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements, tai chi, and yoga to manage chronic pain and related disabilities associated with conditions such as fibromyalgia, back pain, osteoarthritis, neck pain, and severe headaches or migraines.
The safety information available was low overall, but none of the clinical trials reported significant side effects due to the approaches. The results demonstrated that acupuncture and yoga may be effective techniques in treating back pain. Knee osteoarthritis may be treated effectively with acupuncture and tai chi. The researchers found that massage therapy may be effective in treating neck pain, and relaxation techniques are appropriate for treating severe headaches and migraine.
While the evidence was weaker, the results showed that relaxation techniques and tai chi might help people with fibromyalgia, while massage therapy, spinal manipulation, and osteopathic manipulation may help ease back pain.
“These data can equip providers and patients with the information they need to have informed conversations regarding nondrug approaches for treatment of specific pain conditions,” said David Shurtleff, PhD, deputy director of the NCCIH.
“It’s important that continued research explores how these approaches actually work and whether these findings apply broadly in diverse clinical settings and patient populations,” he said.