These integrative therapies may be alternative to opioids

Acupuncture, yoga, and other integrative medicine approaches have shown at least preliminary evidence of effectiveness in pain management, according to an article in the December issue of the journal, Anesthesia & Analgesia.

Yuan-Chi Lin, MD, MPH, a researcher at Harvard Medical School, and lead author of the study, reviewed, and analyzed current evidence on integrative medicine therapies for the treatment of pain.

The analysis included a total of 32 studies evaluating seven different types of integrative medicine therapies for pain. Acupuncture was the treatment showing the strongest evidence for effectiveness in reducing pain. Overall there was "strong positive evidence" showing a beneficial effect of acupuncture for the treatment of chronic pain. There were also studies showing that acupuncture reduced the dose of opioids needed to control pain after surgery, with reduction in opioid-related side effects.

Most of the other therapies studied showed "positive preliminary evidence" of effectiveness in pain treatment. These included yoga, relaxation techniques such as mindfulness meditation, tai chi, massage therapy, and spinal manipulation. Few of these studies addressed the effects on use of prescription medications in general or opioids in particular. There was conflicting evidence on the pain-reducing effectiveness of the supplements glucosamine and chondroitin for knee pain.

The authors acknowledge some important limitations of the current evidence on integrative therapies for pain. The studies in the review varied in terms of the methods used and the types of pain studied, in addition to the special challenges of studying the effectiveness of alternative therapies (such as controlling for the placebo effect).

"The consensus and results of this review suggest that complementary health approaches can help to improve pain and reduce opioid use," says Lin.

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