Scientists evaluated clinical studies on 21 complementary and alternative medicine (CAM) to determine if they help the pain and disability associated with rheumatoid arthritis (RA), osteoarthritis (OA), fibromyalgia and low back pain. Other forms of arthritis and related diseases were not included in the analysis. Of the therapies included in the studies, they rated acupuncture, massage, yoga and tai chi most effective.
These findings don’t mean that other CAM therapies – defined by this report as any therapy that exists outside normal health care practices – aren’t effective. The researchers stress that, in many cases, there just weren’t enough high-quality data to fully evaluate the therapies. “Where there is no or little evidence, it is very difficult to judge,” says lead author of the report, Gareth Jones, PhD, a senior lecturer in epidemiology in the School of Medicine and Dentistry at the University of Aberdeen in Scotland.
The researchers used a 5-point scale to judge the effectiveness of each therapy. A ranking of 1 indicates little to no evidence of efficacy; 5 means there is consistent evidence from high-quality trials that a therapy improved patients’ pain, disability and quality of life.
Acupuncture for Arthritis Pain
Overall, acupuncture got 5s for helping with osteoarthritis and low back pain; it got a 4 for its usefulness in fibromyalgia. The evidence for its effectiveness is so clear, in fact, that Jones says it raises the question of whether acupuncture should continue to be viewed as a CAM therapy. “There’s an argument that maybe this should be part of conventional medicine. When something works, when there is good evidence something works, is it right that it is still a complementary therapy? Probably not,” Jones says, adding that he’d like to see future studies about why CAM therapies work.
Massage for Arthritis Pain
Massage received 5s and was deemed effective for fibromyalgia and low back pain. Results of 50 trials with more than 3,000 participants with fibromyalgia were evaluated to draw that conclusion. In total, the scientists reviewed 75 low back pain studies featuring more than 11,000 patients testing 14 therapies.
Tai Chi for Arthritis Pain
Tai chi was determined effective for osteoarthritis. It was given a rating 4 – indicating a high level of efficacy for dealing with the degenerative joint disease. It was given a rating of 3 for fibromyalgia, indicating there is promising evidence that it may help.
Yoga for Arthritis Pain
Yoga scored a 4 and was found to be effective for low back pain.
Relaxation Therapy for Arthritis Pain
Relaxation therapy received a “promising” rating for fibromyalgia and low back pain.
Other complementary and alternative therapies that were evaluated – but came up short – included aromatherapy, autogenic training, biofeedback, copper bracelets, craniosacral therapy, healing therapies, hypnotherapy, imagery, magnet therapy, meditation, music therapy, qigong and reflexology.
Daniel J. Clauw, MD, professor of medicine in the division of rheumatology at the University of Michigan in Ann Arbor, says he hopes for more high-quality studies comparing the effectiveness of CAM therapies. But he says this 2012 data is more than patients ever had before, which is helpful since CAM therapies often aren’t covered by insurance.
Jones agrees. “Until this came out … there was no guidance. Now there is some. That would be a good place for someone to start if they want to pursue CAM therapies,” Jones says. “Start with the ones that are on the list, but it doesn’t mean that something not on the list won’t work.”
Before you try a CAM therapy, make sure your doctor is supportive, Dr. Clauw says. “The main thing I can help you with is to evaluate if it’s safe,” he explains. “And then it comes down to patient preference. Are they willing to pay out of pocket for a treatment that may or may not work?”
He also recommends trying only one CAM therapy at a time. “Give it a month or two, retain what works and discard what doesn’t,” Dr. Clauw suggests. “If it’s not working after a month or a couple treatments a week, it’s probably best for the patient to check the box saying, ‘This didn’t work,’ and move on.”
- Natural Treatments for Arthritis
- Massage for Arthritis
- Acupuncture for Arthritis
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