A new systemic review study on the data of US clinical trials has revealed that complementary health approaches were found to play an important strategy in pain management instead of medications which sometimes become ineffective or causes unwanted side effects. This review on pain management was published in the Journal of Mayo Clinical Proceedings in 2016.
Generally, pain is an unpleasant physical suffering caused by disease, injury, or anything that hurts the body and may range from acute to chronic distress or discomfort to agony. Medically, pain in health care is not comprehensively assessed and treatment is offered in fragments, thereby patients may encounter difficulty in obtaining a full range of potential treatments. Therefore, a complementary health approach is one of the pharmacological and non-pharmacological strategies to manage pain and includes a broad category of procedures such as practitioner based (eg: acupuncture, massage therapy, spinal manipulation), relaxation techniques (eg: meditation, yoga and tai chi) and dietary supplements (eg: glucosamine and herbal medicines).
In order to understand the role of complementary healthy strategies on pain management, Richard and co-workers of National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (NIH) of United States have conducted a review from 1966 to 2016 on randomized controlled trials (RCTs) that enrolled over 100 participants. In order to determine the efficacy and safety of pharmacological, behavioral, and physical interventions on pain management, reviewers have considered different types of pain (back pain, osteoarthritis, neck pain, severe headaches and migraine, and fibromyalgia) and complementary approaches that include acupuncture, massage therapy, osteopathic or spinal manipulation, massage therapy, relaxation techniques like meditation, yoga, and tai chi, and dietary supplements (eg: chondroitin and glucosamine).
It was observed that there was a positive approach for the use of acupuncture and yoga for managing back pain; acupuncture and tai chi for osteoarthritis of the knee; massage therapy for neck pain with adequate doses and for short-term benefit; and relaxation techniques for severe headaches and migraine. Not much information was provided on the safety of healthy approaches in managing the pain by RCTs. However, it was reported that the most common adverse events (gastrointestinal distress) were noted in trials of dietary supplements (glucosamine, chondroitin, MSM, SAMe). In some cases, tai chi and yoga were associated with minor muscle or joint soreness while acupuncture was with minor pain and/or bruising at the needling site.
In summary, complementary approaches have a significant impact on health conditions and improve the severity, disability or function of pain without causing any adverse effect. Size and quality of RCTs, following proper statistical approaches along with treatment protocols or algorithms in complementary approaches to pain management would have confirmed the conclusions of NCCIH review study. Further, RCT studies other than the United States might reveal a different set of healthy approaches to be followed in pain management.
Written By: Manche Santoshi, PhD