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NCCIH Research Blog

New Review Offers Providers and Researchers Evidence-Based Information on Complementary Health Approaches for Pain

September 1, 2016

Richard L. Nahin, Ph.D., M.P.H.

Richard L. Nahin, Ph.D., M.P.H.

Lead Epidemiologist

National Center for Complementary and Integrative Health

View biographical sketch

Today, Mayo Clinic Proceedings published a review, “Evidence-based Evaluation of Complementary Health Approaches for Pain Management in the United States,” which I authored, along with several NCCIH colleagues.

We know that while most pain is acute and improves within a short time, millions of Americans suffer from more persistent pain that may become chronic and debilitating over time.

Medications may not completely relieve chronic pain or can produce unwanted side effects. As a result, many people may turn to complementary health approaches to help manage their pain. Our overall goal was to summarize the evidence-base on what is safe and effective when it comes to complementary approaches for pain.

We reviewed U.S.-based clinical trials on popular complementary approaches used to treat some of the most common pain conditions in America: back pain, knee osteoarthritis, neck pain, and severe headaches and migraines. These are all pain conditions that would be treated in a primary care setting. We also reviewed the data on fibromyalgia. While this condition is not as common as the other conditions in the review, individuals with fibromyalgia frequently use a variety of complementary approaches.

For each painful condition, we reviewed data on the safety and effectiveness of acupuncture, spinal manipulation, massage therapy, relaxation techniques including meditation, certain natural product supplements, tai chi, and yoga.

One major goal for this study was to be as relevant as possible to primary care providers in the United States, who frequently see and care for patients with painful conditions. Providers need more high quality information on the evidence base for pain management tools, especially nondrug approaches.

For the review, we identified 105 U.S.-based randomized controlled trials published between 1966 and 2016 that met our inclusion criteria and were relevant to pain patients in the United States. Overall, the data suggest that some complementary approaches may help some patients manage, though not cure, painful health conditions. This includes yoga and acupuncture for back pain; acupuncture and tai chi for osteoarthritis pain of the knee; massage therapy for neck pain; and relaxation techniques for severe headaches and migraine.

Although the evidence was weaker, the data indicate that massage therapy, spinal manipulation, and osteopathic manual therapy may provide some help to people with back pain. Relaxation approaches and tai chi may help those with fibromyalgia.

You may be interested in reading details about the review, including methodology and limitations, on the NCCIH website.

In addition, the two Question and Answer videos below were taped with my colleagues (and co-authors) and may be of interest to you. Dr. Partap Khalsa, Deputy Director of the Division of Extramural Research at NCCIH, discussed ideas for future research on complementary health approaches for pain management and research that addresses the needs of diverse populations.

Dr. Wendy Weber, Chief of the Clinical Research in Complementary and Integrative Health Branch at NCCIH, discussed whether this review answers questions about what works and what doesn’t, as well as how these approaches work.

Let us know your thoughts on this study and future research of complementary health approaches for pain!


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