Some "natural" techniques can help ease pain, including acupuncture, yoga, tai chi and massage, government researchers said Thursday.
A review of high-quality studies shows these approaches rarely cause any harm and can help people with lower back pain, headaches and arthritic knees, the team at the National Center for Complementary and Integrative Health found.
They found evidence that:
- Acupuncture and yoga can help back pain
- Acupuncture and tai chi can help osteoarthritis of the knee
- Massage therapy gives short-term relief for neck pain
- Relaxation techniques can ease severe headaches and migraine.
The study found weaker evidence that massage therapy and techniques offered by chiropractors such as spinal manipulation, as well as osteopathic manipulation, may help some back pain.
Relaxation approaches and tai chi may help people with fibromyalgia, the team reports in the Mayo Clinic Proceedings.
"Back pain, joint pain, neck pain, and headaches are among the most common types of pain experienced by U.S. adults," the team, led by Richard Nahin at the NCCIH, part of the National Institutes of Health, wrote.
"National surveys going back more than 25 years have consistently found that these complementary approaches are used by about 30 percent to 40 percent of the U.S. public in a given year."
Americans spend more than $14 billion of their own money on complementary treatment to manage their pain. In addition, the Centers for Disease Control and Prevention says people with many types of pain should try such complementary approaches, as well as the tried-and-true technique of using ice to numb pain and reduce swelling, before turning to drugs — especially strong drugs such as opioids.
That made it worth checking whether such approaches work.
The NCCIH team looked at clinical trials that randomly assigned people to get the real treatment, a placebo or another treatment. That way they can see if the treatment being assessed really makes a difference.
"The randomized, controlled clinical trial is considered the strongest study design for investigating the efficacy and safety of pharmacological, behavioral, and physical interventions," the team wrote.
There are not very many of these trials looking at complementary medicine, and many of them only enrolled a few people. But they found four looking at acupuncture to treat lower back pain, for instance, and two of them showed the approach reduced pain in some people.
Two studies found massage helped lower back pain in the short term, but the benefits wore off after a year.
Yoga helped lower back pain, too, but so did other forms of exercise. "Compared with usual care, two studies found that yoga provided improvements in pain and function, but the results were mixed when compared with exercise/stretching," the team wrote.
It was difficult to find consistent trials looking at the supplements glucosamine and chondroitin for knee pain from arthritis, the team found, and the results were mixed and not very clear. Supplements in general sometimes caused gastrointestinal side-effects. Acupuncture sometimes hurt and caused bruising.
"For most complementary approaches, there are no standard treatment protocols or algorithms, and in the case of dietary supplements, no rigorously established dosages and products," the team noted.