Skip to main content

Advertisement

Log in

Complementary and Alternative Medicine for Pain: An Evidence-based Review

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Pain is one of the most prevalent conditions for which patients seek medical attention. Additionally, the number of patients who utilize complementary and alternative medicine as a treatment of pain either in lieu of, or concurrent with, standard conventional treatments continues to grow. While research into the mechanisms, side effect profiles, and efficacies of these alternative therapies has increased in recent years, much more remains unknown and untested. Herein, we review the literature on complementary and alternative medicine for pain, with particular emphasis on evidence-based assessments pertinent to the most common alternative therapies, including acupuncture, herbal therapy, massage therapy, hypnosis, tai chi, and biofeedback.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Kennedy J, Herb and supplement use in the US adult population. Clin Ther., 2005. 27: p. 1847–1858.

    Article  PubMed  Google Scholar 

  2. Acupuncture for pain. National Center for Complementary and Alternative Medicine. , 2009. Publication No.D435.

  3. NIH consensus development panel on acupuncture. JAMA, 1998. 280(17): p. 1518–24.

  4. Pomeranz B, Stux G, eds. Scientific Bases of Acupuncture. New York: Springer-Verlag; 1989.

    Google Scholar 

  5. •• Wang SM, Kain ZN, and White P, Acupuncture Analgesia: I. The Scientific Basis. Anesth Analg., 2008. 106(2): p. 602–10. This is an important review of acupuncture with emphasis on the scientific and neurophysiologic basis of its efficacy and postulated mechanisms.

    Article  PubMed  Google Scholar 

  6. Han JS, Physiology of acupuncture: review of thirty years of research. J Altern Complement Med, 1997. (Suppl 1): p. S101–8.

  7. Cheng RS and Pomeranz BH, Electroacupuncture analgesia is mediated by stereospecific opiate receptors and is reversed by antagonists of type I receptors. Life Sci. , 1980. 26(8): p. 631–8.

    Article  CAS  PubMed  Google Scholar 

  8. Han JS and Sun SL, Differential release of enkephalin and dynorphin by low and high frequency electroacupuncture in the central nervous system. Acupunct Sci Int J., 1990. 1: p. 19–27.

    Google Scholar 

  9. Wu MT, Hsieh JC, Xion J, et al., Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain—preliminary experience. Radiology., 1999. 212(1): p. 133–41.

    CAS  PubMed  Google Scholar 

  10. Zhang W, Jin Z, Huang J, et al., Modulation of cold pain in human brain by electric acupoint stimulation: evidence from fMRI. Neuroreport., 2003. 14(12): p. 1591–6.

    Article  PubMed  Google Scholar 

  11. Napadow V, Makris N, Lui J, et al., Effects of electroacupuncture versus manual acupuncture by fMRI. Hum Brain Mapp. , 2005. 24(3): p. 193–205.

    Article  PubMed  Google Scholar 

  12. Trinh KV, Philips SD, and Ho, E. Acupuncture for neck disorders., in Cochrane Database Syst Rev. 2006.

  13. Vas J, Perea-Milla E, Mednez C, et al., Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomized controlled study. Pain., 2006. 126(1–3): p. 245–55.

    Article  PubMed  Google Scholar 

  14. Green S, Buchbinder R, and Hetrick S, Acupuncture for shoulder pain. , in Cochrane Database Syst Rev. 2005.

  15. Lathia AT, Jung SM, and Chen LX, Efficacy of acupuncture as a treatment for chronic shoulder pain. J Altern Complement Med. , 2009. 15(6): p. 613–8.

    Article  PubMed  Google Scholar 

  16. Trinh KV, Phillips SD, and Ho E, Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology, 2004. 43(9): p. 1085–90.

    Article  CAS  PubMed  Google Scholar 

  17. Linde K, Allais G, Brinkhaus B, et al., Acupuncture for tension-type headache. , in Cochrane Database Syst Rev. 2009. p. 1:CD007587.

  18. Assefi NP, Sherman KJ, Jacobsen C, et al., A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern. Med, 2005. 143(1): p. 10–21.

    PubMed  Google Scholar 

  19. Martin DP, Sletten CD, Williams BA, et al., Improvement in fibromyalgia symptoms with acupuncture: results of a randomized controlled trial. Mayo Clin Proc., 2006. 81(6): p. 749–57.

    Article  PubMed  Google Scholar 

  20. Martin-Sanchez E, Torralba E, Diaz-Dominguez, et al., Efficacy of acupuncture for the treatment of fibromyalgia: a systematic review and meta-analysis of randomized trials. Open Rheumatol J., 2009. 3: p. 25–9.

    Google Scholar 

  21. Brinkausb B, Witt CM, Jena S, et al., Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Inter Med., 2006. 166(4): p. 450–7.

    Article  Google Scholar 

  22. Cherkin DC, Sherman KJ, Avins AL, et al., A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med, 2009. 169(9): p. 858–66.

    Article  PubMed  Google Scholar 

  23. Haake M, Muller HH, Schade-Brittinger C, et al., German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med., 2007. 167(17): p. 1892–8.

    Article  PubMed  Google Scholar 

  24. Manheimer E, Linde K, Lao L, et al., Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med., 2007. 146(12): p. 868–77.

    PubMed  Google Scholar 

  25. Scharf HP, Mansmann U, Streitberger K, et al., Acupuncture and knee osteoarthritis: a three-armed randomized trial. Ann Intern Med., 2006. 145(1): p. 12–20.

    PubMed  Google Scholar 

  26. Jubb RW, Tukamachi ES, Jones PW, het al., A blinded randomised trial of acupuncture (manual and electroacupuncture) compared with a non-penetrating sham for the symptoms of osteoarthritis of the knee. Acupunct Med, 2008. 26(2): p. 69–78.

    Article  PubMed  Google Scholar 

  27. Stewart WF, Shechter A, and Rasmussen BK, Migraine prevalence. A review of population-based studies. Neurology., 1994. 44: p. S17.

    CAS  PubMed  Google Scholar 

  28. Deyo RA, Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine, 1987. 12: p. 264.

    Article  CAS  PubMed  Google Scholar 

  29. Heptinstall S, White A, Williamson L, et al., Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet., 1985. 1(8437): p. 1071–4.

    Article  CAS  PubMed  Google Scholar 

  30. Pittler MH and Ernst E, Feverfew for preventing migraine., in Cochrane Database Syst Rev. 2004.

  31. Chrubasik S, Zimpfer CH, Schutt U, et al., Effectiveness of harpagophytum procumbens in the treatment of acute low back pain. Phytomedicine., 1996. 3: p. 1–10.

    Google Scholar 

  32. Gagnier JJ, van Tulder M, Berman B, et al., Herbal medicine for low back pain., in Cochrane Database Syst Rev. 2006.

  33. • Rubinstein SM, van Middelkoop M, Kuijpers T, et al., A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain. Eur Spine J., 2010. 19(8): p. 1213–28. This is a thorough systematic review that highlights the various complementary and alternative treatment options available for the treatment of low back pain.

    Article  PubMed  Google Scholar 

  34. Chrubasik S, Zimpfer CH, Schutt U, Ziegler R. Effectiveness of harpagophytum procumbens in the treatment of acute low back pain. Phytomedicine 1996;3:1–10.

    Google Scholar 

  35. Chrubasik S, Junck H, Breitschwerdt H, Conradt C, Zappe H. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebocontrolled, double-blind study. European Journal of Anaesthesiology1999;16:118–29.

    CAS  PubMed  Google Scholar 

  36. Chrubasik S, Model A, Black A, Pollak S. A randomized doubleblind pilot study comparing Doloteffin and Vioxx in the treatment of low back pain. Rheumatology 2003;42:141–8.

    Article  CAS  PubMed  Google Scholar 

  37. Chrubasik S, Eisenberg E, Balan E, et al., Treatment of low back pain exacerbations with willow bark extract: A randomized Double-Blind Study. American Journal of Medicine., 2000. 109(9–14).

    Google Scholar 

  38. Chrubasik S, Kunzel O, Model A, et al., Treatment of low back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology, 2001. 40: p. 1388–93.

    CAS  Google Scholar 

  39. Krivoy N, Pavlotzky E, Chrubasik S, et al., Effects of salicis cortex extract on human platelet aggregation. Planta Medica., 2000. 67: p. 209–12.

    Article  Google Scholar 

  40. Melzack R and Wall PD, The Challenge of Pain. 1996, London, UK:: Penguin Books.

    Google Scholar 

  41. • Imamura M, Furlan AD, Dryden T, et al., Evidence-informed management of chronic low back pain with massage. Spine J., 2008. 8(1): p. 121–33. This is a thorough review of massage for the management of low back pain.

    Article  PubMed  Google Scholar 

  42. Furlan AD, Imamura M, Dyrden T, et al., Massage for low-back pain., in Cochrane Database Syst Rev. 2008.

  43. Furlan AD, Imamura M, Dyrden T, et al., Massage for low back pain: an updated systematic review within the framework of the Cochrane Back Review Group. Spine., 2009. 34(16): p. 1669–84.

    Article  PubMed  Google Scholar 

  44. Faymonville ME, Laureys S, Degueldre C, et al., Neural mechanisms of antinociceptive effects of hypnosis. Anesthesiology., 2000. 92(5): p. 1257–67.

    Article  CAS  PubMed  Google Scholar 

  45. Grondahl JR and Rosvold EO, Hypnosis as a treatment of chronic widespread pain in general practice: a randomized controlled pilot trial. BMC Musculoskelet Disord., 2008. 9: p. 124.

    Article  PubMed  Google Scholar 

  46. Jones H, Cooper P, Miller V, et al., Treatment of non-cardiac chest pain: a controlled trial of hypnotherapy. Gut., 2006. 55(10): p. 1403–8.

    Article  CAS  PubMed  Google Scholar 

  47. Hall A, Maher C, Latimer J, et al., The effectiveness of Tai Chi for chronic musculoskeletal pain conditions: a systemic review and meta-analysis. Arthritis Rheum., 2009. 61(1): p. 717–24.

    Article  PubMed  Google Scholar 

  48. • Uhlig T, Fongen C, Steen E, et al., Exploring Tai Chi in rheumatoid arthritis: a quantitative and qualitative study. BMC Musculoskelet Disord., 2010. 11: p. 43. This is an interesting and thought-provoking study on the use of tai chi for rheumatoid arthritis.

    Article  PubMed  Google Scholar 

  49. Wang C, Schmid CH, Hibberd PL, et al., Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Rheum. , 2009. 61(11): p. 1545–53.

    Article  PubMed  Google Scholar 

  50. Wang C, Schmid CH, Rones R, et al., A randomized trial of tai chi for fibromyalgia. N Engl J Med., 2010. 363(8): p. 743–54.

    Article  CAS  PubMed  Google Scholar 

  51. Crider A, Glaros AG, and Gevirtz RN, Efficacy of biofeedback-based treatments for temporomandibular disorders. Applied Psychophysiology and Biofeedback., 2005. 30(4): p. 333–345.

    Article  PubMed  Google Scholar 

  52. Dursun N, Dursun E, and Kilic Z, Electromyographic biofeedback-controlled exercise versus conservative care for patellofemoral pain syndrome. Archives of Physical Medicine and Rehabilitation., 2001. 82(12): p. 1692–1695.

    Article  CAS  PubMed  Google Scholar 

  53. Kayıran S, Dursun E, Dursun N, et al., Neurofeedback Intervention in Fibromyalgia Syndrome; a Randomized, Controlled, Rater Blind Clinical Trial. Appl Psychophysiol Biofeedback, 2010(Jul 8.): p. [Epub ahead of print].

  54. Kayıran S, Dursun E, Dursun N, Ermutlu N, Karamürsel S. Neurofeedback Intervention in Fibromyalgia Syndrome; a Randomized, Controlled, Rater Blind Clinical Trial. Appl Psychophysiol Biofeedback. 2010 Jul 8.

  55. Caruso TJ, Prober CG, and Gwaltney JM Jr, Treatment of naturally acquired common colds with zinc: a structured review. Clin Infect Dis., 2007. 45(5): p. 569–74.

    Article  CAS  PubMed  Google Scholar 

Download references

Disclosures

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Adam J. Carinci.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dhanani, N.M., Caruso, T.J. & Carinci, A.J. Complementary and Alternative Medicine for Pain: An Evidence-based Review. Curr Pain Headache Rep 15, 39–46 (2011). https://doi.org/10.1007/s11916-010-0158-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-010-0158-y

Keywords

Navigation