Clinical evidence for integrative healthcare approaches to pain

Approximately 40 million Americans experience severe pain annually, costing more than $14 billion in out-of-pocket expenses. A MEDLINE database search was done for randomized, controlled clinical trials published from 1966 to 2016 and conducted in the United States, with evidence of efficacy, effectiveness and safety. Researchers chose seven, widely used complementary approaches including: acupuncture, spinal manipulation, massage therapy, tai chi and relaxation techniques using meditation. Also included in the search were selected natural products; chondroitin, glucosamine, methylsulfonylmethane (MSM), S-adenosyl-L-methionine (SAM-e) and omega-3 fatty acids. The researchers found the following approaches had more positive than negative results. Negative results were minor side effect symptoms, related to supplements and some temporary gastric upset. No trials reported serious adverse events with treatments.

  • Acupuncture and yoga for back pain
  • Acupuncture and tai chi for osteoarthritis of the knee
  • Massage therapy for neck pain – with adequate doses and for short-term benefit.
  • Relaxation techniques for severe headaches and migraines.

Weaker evidence was found for:

  • Massage therapy, spinal manipulation for back pain
  • Relaxation approaches and tai chi for fibromyalgia

https://nccih.nih.gov/research/results/spotlight/five-painful-conditions?nav=govd