1. Effects of reflexology on fibromyalgia symptoms: a multiple case study.

Gunnarsdottir TJ, Peden-McAlpine C.

http://www.ncbi.nlm.nih.gov/pubmed/20621279

 

Source

Faculty of Nursing, University of Iceland, Reykjavik, Iceland. stalolaz@logosnet.cy.net

Abstract

PURPOSE:

To explore the effects of reflexology on pain and other symptoms in women with fibromyalgia syndrome [FM].

METHODS:

Multiple case study method as developed by Stake was used to investigate the effects of reflexology on six cases of women with FM which were given ten sessions of weekly reflexology. Data were collected with observation, interviews and diary and then analyzed within cases and across cases.

RESULTS:

Reflexology affected the symptom of pain in multiple areas such as head, neck and arms. Pain started to isolate and decrease.

CONCLUSION:

Reflexology may be helpful to decrease fibromyalgia symptoms. Qualitative research methods and individually tailored interventions are important when researching complementary and alternative therapies.

Copyright 2010 Elsevier Ltd. All rights reserved.

PMID: 20621279

[PubMed - indexed for MEDLINE]

 

2. The role of exercise and alternative treatments for low back pain.

Carneiro KA, Rittenberg JD.

http://www.ncbi.nlm.nih.gov/pubmed/20977960

 

Source

Department of Physical Medicine and Rehabilitation, University of North Carolina, CB#7200, Chapel Hill, NC 27599, USA. kevcar99@gmail.com

Abstract

The determination of whether a patient should pursue an active or passive treatment program is often made by medical practitioners. Knowledge about all forms of treatment, including complementary and alternative (CAM) treatments, is essential in the treatment of low back pain. Medical practitioner-directed active treatments that have been shown to be effective for the treatment of low back pain include physical therapy-directed exercise programs such as core stabilization and mechanical diagnosis and therapy (MDT). Based on the current literature, it appears that yoga is the most effective nonphysician-directed active treatment approach to nonspecific low back pain when comparing other CAM treatments. Acupuncture is a medical practitioner-directed passive treatment that has been shown to be a good adjunct treatment. More randomized controlled studies are needed to support both CAM treatments and exercise in the treatment of low back pain.

Copyright © 2010 Elsevier Inc. All rights reserved.

PMID: 20977960

[PubMed - indexed for MEDLINE]

 

3. Participating in and delivering the ATEAM trial (Alexander technique lessons, exercise, and massage) interventions for chronic back pain: A qualitative study of professional perspectives.

Beattie A, Shaw A, Yardley L, Little P, Sharp D.

http://www.ncbi.nlm.nih.gov/pubmed/20688257

 

Source

Department of Social Medicine, Canynge Hall, University of Bristol, 39 Whatley Road, Bristol BS8 2PR, United Kingdom. Angela.Beattie@bristol.ac.uk

Abstract

OBJECTIVES:

To outline professionals' experiences of participation, perceived benefits and acceptability of the interventions delivered in the ATEAM trial (Alexander technique lessons, exercise, and massage), for patients with chronic or recurrent back pain.

DESIGN:

Qualitative study using in-depth interviews was conducted with a purposeful sample of twenty professionals (general practitioners (GPs), nurses, Alexander technique teachers, and massage therapists). Data were recorded, transcribed, and analysed thematically using the constant comparison method.

RESULTS:

Evidence of effectiveness GPs wanted an evidence base for the interventions, whilst nurses, Alexander technique teachers and massage therapists perceived patient reports of benefit as evidence. Professionals' perception of the acceptability of the intervention: professional perspectives differed, with GPs and nurses viewing the structured nature of exercise prescription and Alexander technique lessons as more beneficial and acceptable than massage in alleviating patients' back pain. Economic cost: the cost to patients pursuing Alexander technique lessons and massage was perceived to be a barrier outside the trial. Inter-professional communication: there was little communication between the professionals groups within the trial.

CONCLUSIONS:

Valuable insights have been gained into the perceived benefits and acceptability of exercise, Alexander technique lessons and massage as interventions for chronic back pain. Lessons in the Alexander technique with or without exercise, was perceived as more beneficial and acceptable than massage by professionals who participated and delivered the ATEAM trial interventions.

Copyright 2010 Elsevier Ltd. All rights reserved.

PMID: 20688257

[PubMed - indexed for MEDLINE]

 

4. Use of complementary and alternative medicine by patients with arthritis.

Unsal A, Gözüm S

http://www.ncbi.nlm.nih.gov/pubmed/20492058

.

Source

Ahi Evran University School of Health, Ahi Evran Universitesi Sağlik Yüksekokulu, Turkey.

Abstract

AIMS AND OBJECTIVES:

The aims of this study were to determine the prevalence of complementary and alternative medicine use in patients with arthritis, the types of complementary and alternative medicine used, pertinent socio-demographic factors associated with complementary and alternative medicine use and its perceived efficacy.

BACKGROUND:

Arthritis is a major health issue, and the use of complementary and alternative medicine among patients with arthritis is common.

DESIGN:

This is a descriptive cross-sectional study.

METHODS:

Data were obtained from 250 patients with arthritis at the physiotherapy and immunology clinics Atatürk University Hospital in eastern Turkey between May-July 2005 using a questionnaire developed specifically for this study. The instrument included questions on socio-demographic information, disease specifics and complementary and alternative medicine usage.

RESULTS:

Seventy-six per cent of participants reported use of at least one form of complementary and alternative medicine in the previous year. Complementary and alternative medicine users and non-users were not significantly different in most socio-demographic characteristics including age, gender, marital status and education level with the exception of economic status. We categorised treatment into six complementary and alternative medicine categories: 62.6% of patients used thermal therapies; 41.5% used oral herbal therapies; 40.5% used hot therapies; 32.6% used externally applied (skin) therapies; 28.4% used massage and 12.6% used cold therapies. All forms of complementary and alternative medicine except thermal and oral herbal therapies were perceived as very effective by more than half of study participants.

CONCLUSIONS:

Complementary and alternative medicine therapy is widely used by patients with arthritis and has perceived beneficial effects.

RELEVANCE TO CLINICAL PRACTICE:

It is important for nurses and other health care professionals to be knowledgeable about the use of complementary and alternative medicine therapies when providing care to patients with arthritis because of possible interactions with other treatments, delays in seeking care and the potential for poor quality products. It is also essential for health professionals to discuss treatment options with patients and to monitor treatment efficacy.

PMID: 20492058

[PubMed - indexed for MEDLINE

 

5. Warm-needling plus Tuina relaxing for the treatment of carpal tunnel syndrome.

Cai DF.

http://www.ncbi.nlm.nih.gov/pubmed/20397458

 

 

Source

Zhangjiagang First Municipal People's Hospital, Zhangjiagang, Jiangsu 215600, China.

Abstract

OBJECTIVE:

To probe into quick and effective therapies for carpal tunnel syndrome.

METHODS:

Totally 98 cases of carpal tunnel syndrome were randomly divided into a treatment group and a control group. The treatment group received warm-needling plus Tuina relaxing, while the control group was treated by hormone block therapy and drug medication.

RESULTS:

The cure rate was 81.7% in the treatment group and 47.4% in the control group, with a significant difference between the two groups (P < 0.01).

CONCLUSION:

Acupuncture plus Tuina manipulation is a simple therapy for carpal tunnel syndrome, but with remarkable therapeutic effects.

PMID: 20397458

[PubMed - indexed for MEDLINE]

 

6. Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles.

Draper DO, Mahaffey C, Kaiser D, Eggett D, Jarmin J.

http://www.ncbi.nlm.nih.gov/pubmed/20331373

 

Source

Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA.

Abstract

ABSTRACT Many trigger point therapies, such as deep pressure massage and injection, are painful. Thermal ultrasound might be a comfortable procedure used to soften trigger points. Our objective was to compare thermal ultrasound with sham ultrasound in the ability to soften trigger points with pretest/posttest repeated-measures design for depth of tissue in a massage therapy clinic. Twenty-six patients with latent trigger points in their upper trapezius muscles were studied. Independent variables were treatments; dependent variables were tissue depth. Subjects were randomly assigned to either the treatment or sham group. The study was single-blinded; the investigator taking the measurements was blinded to which group the subjects were in, and the clinician treating with ultrasound was blinded to the measurements. Each trigger point in the treatment group received 3 MHz ultrasound at the following parameters: 1.4 W/cm(2), 5 min, circular motion, 2x the size of the 7 cm(2) soundhead. The ultrasound was not turned on for the sham group. This procedure was repeated one week later. Trigger point depth was measured with a pressure algometer before and immediately after each treatment. A 2 x 2 x 2 repeated measures ANOVA was used to analyze depth (mm). The immediate effects were as follows: The mean depth value for the sham group was an increase of 0.64+/-0.33 mm; the treatment group's mean increase was 2.65+/-0.33 mm (F(1,24)=19.01; p=0.01). The residual effects were as follows: The two treatments over the course of the 2 weeks also showed that the trigger points of the ultrasound groups got softer with an increase in depth of 2.09+/-0.82 mm compared to -0.93+/-0.82 mm of the sham group (F(1,24)=6.81; p<0.01). Thermal ultrasound over latent trigger points is comfortable and can decrease stiffness of a trigger point.

PMID: 20331373

[PubMed - indexed for MEDLINE]

 

7. Using Guasha to treat musculoskeletal pain: a systematic review of controlled clinical trials.

Lee MS, Choi TY, Kim JI, Choi SM.

http://www.ncbi.nlm.nih.gov/pubmed/20205902

 

Source

Acupuncture, Moxibustion and Meridian Research Center, Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon, South Korea. mslee@kiom.re.kr

Abstract

BACKGROUND:

Guasha is a therapeutic method for pain management using tools to scrape or rub the surface of the body to relieve blood stagnation. This study aims to systematically review the controlled clinical trials on the effectiveness of using Guasha to treat musculoskeletal pain.

METHODS:

We searched 11 databases (without language restrictions): MEDLINE, Allied and Complementary Medicine (AMED), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Korean Studies Information (KSI), DBPIA, Korea Institute of Science and Technology Information (KISTI), KoreaMed, Research Information Service System (RISS), China National Knowledge Infrastructure (CNKI) and the Cochrane Library. The search strategy was Guasha (OR scraping) AND pain. Risk of bias was assessed with the Cochrane criteria (i.e. sequence generation, blinding, incomplete outcome measures and allocation concealment).

RESULTS:

Five randomized controlled trials (RCTs) and two controlled clinical trials (CCTs) were included in the present study. Two RCTs compared Guasha with acupuncture in terms of effectiveness, while the other trials compared Guasha with no treatment (1 trial), acupuncture (4 trials), herbal injection (1 trial) and massage or electric current therapy (1 trial). While two RCTs suggested favorable effects of Guasha on pain reduction and response rate, the quality of these RCTs was poor. One CCT reported beneficial effects of Guasha on musculoskeletal pain but had low methodological quality.

CONCLUSION:

Current evidence is insufficient to show that Guasha is effective in pain management. Further RCTs are warranted and methodological quality should be improved.

PMID: 20205902

[PubMed]

PMCID: PMC2827462

 

8. Traditional Chinese medicine in the treatment of rheumatoid arthritis: a general review.

Zhang P, Li J, Han Y, Yu XW, Qin L.

http://www.ncbi.nlm.nih.gov/pubmed/20204371

 

Source

The Translational Medicine R&D Center, Shen Zhen Institute of Advanced Technology, Chinese Academy of Science, Shen Zhen, GuangDong Province, China. superzhangpeng@sina.com

Abstract

Rheumatoid arthritis (RA) is difficult to cure. Many methods have been used for its treatment, among which traditional Chinese medicine (TCM) has been considered as an important strategy. All of the three parts of TCM: Chinese herbs, acupuncture, and massage have been reported with varying degrees of therapeutic effects on RA. Also the mechanism exploration is under process. Many effective ingredients of anti-rheumatic Chinese herbs have been found to inhibit RA development and some of the effective ingredients have been verified. Furthermore, greatly enhanced life quality of RA patients was obtained using acupuncture and massage to relieve pain, expand joint motion and modulate emotion which mainly correlated with the possible modulation of immune system, nerve system, endocrine system, etc. Thus, a systemic review on the therapeutic effect of TCM on RA is necessary. In our paper, the current status of TCM application in the clinic for the therapy of RA was summarized accompanied with the related mechanism exploration using modern test facilities.

PMID: 20204371

[PubMed - indexed for MEDLINE]

 

9. Integrative care for the management of low back pain: use of a clinical care pathway.

Maiers MJ, Westrom KK, Legendre CG, Bronfort G.

http://www.ncbi.nlm.nih.gov/pubmed/21034483

 

Source

Northwestern Health Sciences University, 2501 W 84th St Bloomington, MN 55431, USA. mmaiers@nwhealth.edu

Abstract

BACKGROUND:

For the treatment of chronic back pain, it has been theorized that integrative care plans can lead to better outcomes than those achieved by monodisciplinary care alone, especially when using a collaborative, interdisciplinary, and non-hierarchical team approach. This paper describes the use of a care pathway designed to guide treatment by an integrative group of providers within a randomized controlled trial.

METHODS:

A clinical care pathway was used by a multidisciplinary group of providers, which included acupuncturists, chiropractors, cognitive behavioral therapists, exercise therapists, massage therapists and primary care physicians. Treatment recommendations were based on an evidence-informed practice model, and reached by group consensus. Research study participants were empowered to select one of the treatment recommendations proposed by the integrative group. Common principles and benchmarks were established to guide treatment management throughout the study.

RESULTS:

Thirteen providers representing 5 healthcare professions collaborated to provide integrative care to study participants. On average, 3 to 4 treatment plans, each consisting of 2 to 3 modalities, were recommended to study participants. Exercise, massage, and acupuncture were both most commonly recommended by the team and selected by study participants. Changes to care commonly incorporated cognitive behavioral therapy into treatment plans.

CONCLUSION:

This clinical care pathway was a useful tool for the consistent application of evidence-based care for low back pain in the context of an integrative setting.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00567333.

PMID: 21034483

[PubMed - indexed for MEDLINE]

PMCID: PMC2984498

  

10. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: economic evaluation.

Hollinghurst S, Sharp D, Ballard K, Barnett J, Beattie A, Evans M, Lewith G, Middleton K, Oxford F, Webley F, Little P.

http://www.ncbi.nlm.nih.gov/pubmed/19074232

 

Source

Academic Unit of Primary Health Care,UniversityofBristol,BristolBS8 2AA. s.p.hollinghurst@bristol.ac.uk

Abstract

OBJECTIVE:

An economic evaluation of therapeutic massage, exercise, and lessons in the Alexander technique for treating persistent back pain.

DESIGN:

Cost consequences study and cost effectiveness analysis at 12 month follow-up of a factorial randomised controlled trial.

PARTICIPANTS:

579 patients with chronic or recurrent low back pain recruited from primary care.

INTERVENTIONS:

Normal care (control), massage, and six or 24 lessons in the Alexander technique. Half of each group were randomised to a prescription for exercise from a doctor plus behavioural counselling from a nurse.

MAIN OUTCOME MEASURES:

Costs to the NHS and to participants. Comparison of costs with Roland-Morris disability score (number of activities impaired by pain), days in pain, and quality adjusted life years (QALYs). Comparison of NHS costs with QALY gain, using incremental cost effectiveness ratios and cost effectiveness acceptability curves.

RESULTS:

Intervention costs ranged from pound30 for exercise prescription to pound596 for 24 lessons in Alexander technique plus exercise. Cost of health services ranged from pound50 for 24 lessons in Alexander technique to pound124 for exercise. Incremental cost effectiveness analysis of single therapies showed that exercise offered best value ( pound61 per point on disability score, pound9 per additional pain-free day, pound2847 per QALY gain). For two-stage therapy, six lessons in Alexander technique combined with exercise was the best value (additional pound64 per point on disability score, pound43 per additional pain-free day, pound5332 per QALY gain).

CONCLUSIONS:

An exercise prescription and six lessons in Alexander technique alone were both more than 85% likely to be cost effective at values above pound20 000 per QALY, but the Alexander technique performed better than exercise on the full range of outcomes. A combination of six lessons in Alexander technique lessons followed by exercise was the most effective and cost effective option.

Comment in

PMID: 19074232

[PubMed - indexed for MEDLINE]

Free full text

 

11. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain.

Little P, Lewith G, Webley F, Evans M, Beattie A, Middleton K, Barnett J, Ballard K, Oxford F, Smith P, Yardley L, Hollinghurst S, Sharp D.

http://www.ncbi.nlm.nih.gov/pubmed/19096019

 

Source

Community Clinical Sciences Division,SouthamptonUniversity, Aldermoor Health Centre,Southampton,UK. psl3@soton.ac.uk

Abstract

OBJECTIVE:

To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain.

DESIGN:

Factorial randomised trial. Setting 64 general practices inEngland.

PARTICIPANTS:

579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription.

INTERVENTIONS:

Normal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling.

MAIN OUTCOME MEASURES:

Roland Morris disability score (number of activities impaired by pain) and number of days in pain.

RESULTS:

Exercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks were lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported.

CONCLUSIONS:

One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons.

Republished from

PMID: 19096019

[PubMed]

 

12. Biofeedback is superior to electrogalvanic stimulation and massage for treatment of levator ani syndrome.

Chiarioni G, Nardo A, Vantini I, Romito A, Whitehead WE.

http://www.ncbi.nlm.nih.gov/pubmed/20044997

 

Source

Division of Gastroenterology, University of Verona at Verona, Italy. chiarioni@tin.it

Abstract

BACKGROUND & AIMS:

Levator ani syndrome (LAS) might be treated using biofeedback to teach pelvic floor relaxation, electrogalvanic stimulation (EGS), or massage of levator muscles. We performed a prospective, randomized controlled trial to compare the effectiveness of these techniques and assess physiologic mechanisms for treatment.

METHODS:

Inclusion criteria were Rome II symptoms plus weekly pain. Patients were categorized as "highly likely" to have LAS if they reported tenderness with traction on the levator muscles or as "possible" LAS if they did not. All 157 patients received 9 sessions including psychologic counseling plus biofeedback, EGS, or massage. Outcomes were reassessed at 1, 3, 6, and 12 months.

RESULTS:

Among patients with "highly likely" LAS, adequate relief was reported by 87% for biofeedback, 45% for EGS, and 22% for massage. Pain days per month decreased from 14.7 at baseline to 3.3 after biofeedback, 8.9 after EGS, and 13.3 after massage. Pain intensity decreased from 6.8 (0-10 scale) at baseline to 1.8 after biofeedback, 4.7 after EGS, and 6.0 after massage. Improvements were maintained for 12 months. Patients with only a "possible" diagnosis of LAS did not benefit from any treatment. Biofeedback and EGS improved LAS by increasing the ability to relax pelvic floor muscles and evacuate a water-filled balloon and by reducing the urge and pain thresholds.

CONCLUSIONS:

Biofeedback is the most effective of these treatments, and EGS is somewhat effective. Only patients with tenderness on rectal examination benefit. The pathophysiology of LAS is similar to that of dyssynergic defecation.

2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

PMID: 20044997

[PubMed - indexed for MEDLINE]

PMCID: PMC2847007

Free PMC Article

 

13. Low back pain (chronic).

Chou R.

http://www.ncbi.nlm.nih.gov/pubmed/21418678

 

Source

Oregon Health & Science University, Portland, USA.

Abstract

INTRODUCTION:

Over 70% of people in developed countries develop low back pain (LBP) at some time. But recovery is not always favourable: 82% of non recent-onset patients still experience pain 1 year later. Many patients with chronic LBP who were initially told that their natural history was good spend months or years seeking relief. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments? What are the effects of injection therapy? What are the effects of non-drug treatments? What are the effects of non-surgical and surgical treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

RESULTS:

We found 64 systematic reviews or RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

CONCLUSIONS:

In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acupuncture, analgesics, antidepressants, back schools, behavioural therapy, electromyographic biofeedback, exercise, injections (epidural corticosteroid injections, facet joint injections, local injections), intensive multidisciplinary treatment programmes, lumbar supports, massage, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), non-surgical interventional therapies (intradiscal electrothermal therapy, radiofrequency denervation), spinal manipulative therapy, surgery, traction, and transcutaneous electrical nerve stimulation (TENS).

PMID: 21418678

[PubMed - in process]

 

14. A randomized controlled study on warming needle moxibustion for treatment of knee osteoarthritis.

[Article in Chinese]

Ding MH, Zhang H, Li Y.

http://www.ncbi.nlm.nih.gov/pubmed/19947259

 

Source

College of Acupuncture and Massage, Guangzhou University of TCM, Guangzhou, China.

Abstract

OBJECTIVE:

To assess the short-term and long-term therapeutic effect of warming needle moxibustion for treatment of knee osteoarthritis.

METHODS:

Ninety cases were randomly divided into a warming needle moxibustion group, a western medicine group and a waiting group, 30 cases in each group. The warming needle moxibustion group was treated with warming needle moxibustion on Xuehai (SP 10), Dubi (ST 35) and Zusanli (ST 36), etc.; the western medicine group was treated with oral administration of Ibuprofen sustained release capsule; the waiting group did not receive any treatment. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Chinese version of SF-16 were used to assess the therapeutic effect before treatment, after treatment and 10 weeks after treatment.

RESULTS:

After treatment for 2 weeks, the total effective rate was 86.7% in the warming needle moxibustion group, 90.0% in the western medicine group, and 60.0% in the waiting group, both the warming needle moxibustion group and the western medicine group being significantly better than the waiting group (both P<0.05) and with no significant difference between the warming needle moxibustion group and the western medicine group (P>0.05); 10 weeks after treatment, the total effective rate of 83.3% in the warming needle moxibustion group was better than that of 60.0% in the western medicine group (P<0.05). There were no significant differences in comparison of WOMAC and SF-16 scores after treatment between the warming needle moxibustion group and the western medicine group, and the warming needle moxibustion group in improvement of these scores was superior to the western medicine group (P<0.01, P<0.05).

CONCLUSION:

The therapy of warming needle moxibustion is effective for treatment of knee osteoarthritis, and the short-term therapeutic effect is same as that of oral administration of Ibuprofen and the long-term therapeutic effect is better than that of Ibuprofen.

PMID: 19947259

[PubMed - indexed for MEDLINE]

 

15. Alternative methods of conservative treatment of idiopathic scoliosis.

[Article in English, Polish]

Zarzycka M, Rozek K, Zarzycki M.

http://www.ncbi.nlm.nih.gov/pubmed/19920282

 

Source

Klinika Ortopedii i Rehabilitacji, Wydział Lekarski, Collegium Medicum, Uniwersytet Jagielloński, Zakopane, Poland. karinaroz@op.pl

Abstract

Scoliosis is a deformity of the spine known since Hippocrates times. The value of certain methods of conservative treatment remains controversial. Some of them have only a psychological value both for the physician and his or her caregivers. Based on current literature and the Scoliosis Research Society Report of Alternative Methods of Treatment of Idiopathic Scoliosis, we describe the effectiveness of various alternative methods, such as exercise, Dobosiewicz technique, Karski method, SEAS 02, acupuncture, Alexander technique, aromatherapy, ayurveda, ASCO treatment, biofeedback, chiropractic, Yoga, Feldenkrais method, Pilates method, massage therapy, rolfing, magnet therapy, surface electrical stimulation, PNF, Copes system, and bracing.

PMID: 19920282

[PubMed - indexed for MEDLINE]

 

16. Nonpharmacological correction of low back pain by single or integrated means of medical rehabilitation and the evaluation of their effectiveness.

[Article in Lithuanian]

Sakalauskiene G.

http://www.ncbi.nlm.nih.gov/pubmed/19834312

 

Source

VsI Kauno Silainiu poliklinika. giedre2006@gmail.com

Abstract

Low back pain is a global worldwide problem. A great attention is given to correction of this health status by a wide range of rehabilitation specialists. Some single or integrated physical factors, physiotherapy, specific and nonspecific physical exercises, alternative methods of treatment, also the complex of multidisciplinary rehabilitation means are applied in the management of low back pain. The evidence-based data are analyzed in order to identify which nonpharmacological means are effective in pain correction; in addition, the effectiveness of various methods and models of low back pain management are compared in this article. CONCLUSIONS: Research data evaluating the impact effectiveness of single or integrated means of rehabilitation are very controversial. There are no evidence-based specific recommendations for the correction of this health status objectively assessing advantages of physiotherapy or physical factors and referring the definite indications of their prescription. It is thought that multidisciplinary rehabilitation is most effective in management of chronic low back pain. The positive results depend on the experience of a physician and other rehabilitation specialists. A patient's motivation to participate in the process of pain control is very important. It is recommended to inform a patient about the effectiveness of administered methods. There is a lack of evidence-based trials evaluating the effectiveness of nonpharmacological methods of pain control in Lithuania. Therefore, the greater attention of researchers and administrative structures of health care should be given to this problem in order to develop the evidence-based guidelines for an effective correction of low back pain.

PMID: 19834312

[PubMed - indexed for MEDLINE]

 

17. Application of Delphi technique in identification of appropriate screening questions for chronic low back pain from traditional Chinese medicine experts' opinions.

Guangyi X, Chongsuvivatwong V, Geater A, Ming L, Yun Z.

http://www.ncbi.nlm.nih.gov/pubmed/19769476

 

Source

Yunnan University of Traditional Chinese Medicine, Kunming-650021, Yunnan, People's Republic of China. drxionggycn@yahoo.com.cn

Abstract

OBJECTIVE:

The goal of the present study was to obtain a standard list of traditional Chinese medicine (TCM) symptoms and signs for screening chronic low back pain (cLBP) from a group of experts and to assess agreement and consistency among their opinions on the items of a questionnaire. DESIGN, SETTINGS, AND SUBJECTS: The study design involved three rounds of modified Delphi technique, and it was carried out by 13 experts in orthopedics, massage, and acupuncture working in four hospitals affiliated with Yunnan University of Traditional Chinese Medicine, China.

OUTCOME MEASURES:

The outcome was measured on the 5-score Likert-scale self-administered checklists.

RESULTS:

A review of eight textbooks identified 12 pain characteristics, 11 associated factors, and 25 physical and tongue diagnostic expressions as important factors in the TCM diagnosis of cLBP. These 48 diagnostic characteristics were rated by 13 experts as "not important" to "very important" on a scale of 1-5. After three rounds of rating, 13 characteristics were eliminated from the list, with the final numbers for each group being 8, 11, and 16, respectively. Seven items based on Western medicine were also added by the experts. The intra-class correlation (ICC) coefficient for agreement among the experts was 0.2 at the end. Intra-rater, between rounds, consecutive pair-wise median kappa values were 0.53 and 0.66. Analysis of variance using items appearing in all three rounds revealed significant effects of expert and group of symptoms and signs (p < 0.001) and nonsignificant differences among scores of the same expert in the three rounds (p = 0.97). Mean score of physical and tongue expressions was significantly (p < 0.001) lower than that of all other groups of symptoms and signs.

CONCLUSIONS:

Modern TCM experts have de-emphasized the items on physical and tongue expressions and have adopted instead those from Western medicine. Intra-expert agreement across items was low, and each expert tended to stick to her/his original opinions.

PMID: 19769476

[PubMed - indexed for MEDLINE]

 

18. The effect of cultural background on the usage of complementary and alternative medicine for chronic pain management.

Ho KY, Jones L, Gan TJ.

http://www.ncbi.nlm.nih.gov/pubmed/19461837

 

Source

Pain Management Centre, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. ho.kok.yuen@sgh.com.sg

Abstract

BACKGROUND:

Chronic pain is a debilitating problem with significant impact on healthcare utilization in the US. Many chronic pain patients use complementary or alternative medicine (CAM) in addition to standard pharmacologic therapy.

OBJECTIVE:

The aim of our study was to identify differences in the characteristics of usage of CAM for chronic pain control among several ethnic groups.

DESIGN:

We recruited 92 consecutive patients seeking treatment at the pain clinic and interviewed them using a questionnaire.

RESULTS:

The most common pain complaint was back pain (55.4%) and the mean pain duration for all chronic pain problems was 9.8 years. Approximately 81% of respondents were using or have used CAM before. The commonest CAM used by patients in our study included massage therapy, spiritual healing as well as the consumption of mineral and vitamin supplements. Sixty-three percent of them were satisfied with CAM treatment compared to 56% of patients who were satisfied with prescription therapy. However, there was no difference in the use of CAM among the different ethnic groups (P > 0.05).

CONCLUSION:

Our study demonstrates that CAM is used very frequently in patients with chronic pain. However, it did not show any ethnic or racial differences in CAM utilization.

PMID: 19461837

[PubMed - indexed for MEDLINE]

 

19. Clinical efficacy of kinesiology taping in reducing edema of the lower limbs in patients treated with the ilizarov method--preliminary report.

Białoszewski D, Woźniak W, Zarek S.

http://www.ncbi.nlm.nih.gov/pubmed/19240683

 

Source

Division of Rehabilitation, Department of Physiotherapy, 2nd Medical Faculty, Medical University of Warsaw. bialoszewski@wum.edu.pl

Abstract

INTRODUCTION:

Postoperative edema of predominantly lymphatic origin is a significant hindrance to physiotherapy in patients subjected to limb lengthening by the Ilizarov method. New treatment methods are being sought, and Kinesiology Taping is one of them.

MATERIAL AND METHODS:

The study involved 24 patients of both sexes subjected to lower limb lengthening using the Ilizarov method who had developed edema of the thigh or crus of the lengthened extremity. The mean age of the patients was 21 years. The patients were randomized into two groups of twelve, which were then subjected to 10 days of standard physiotherapy. The study group was additionally treated with Kinesiology Taping (lymphatic application), while the control group received standard lymphatic drainage. Treatment results were assessed by comparing the linear circumferences of the lower limbs before and after the treatment.

RESULTS:

The application of Kinesiology Taping in the study group produced a decrease in the circumference of the thigh and crus statistically more significant than that following lymphatic drainage.

CONCLUSIONS:

1. Both standard edema-reducing treatment in the form of lymphatic massage and Kinesiology Taping significantly reduced lower limb edema in patients treated by the Ilizarov method. 2. The application of Kinesiology Taping in the study group produced a significantly faster reduction of the edema compared to standard lymphatic massage.

PMID: 19240683

[PubMed - indexed for MEDLINE]

 

20. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain.

Little P, Lewith G, Webley F, Evans M, Beattie A, Middleton K, Barnett J, Ballard K, Oxford F, Smith P, Yardley L, Hollinghurst S, Sharp D. http://www.ncbi.nlm.nih.gov/pubmed/18713809

 

Source

Primary Care Group, Community Clinical Sciences Division, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST. psl3@soton.ac.uk

Abstract

OBJECTIVE:

To determine the effectiveness of lessons in the Alexander technique, massage therapy, and advice from a doctor to take exercise (exercise prescription) along with nurse delivered behavioural counselling for patients with chronic or recurrent back pain.

DESIGN:

Factorial randomised trial.

SETTING:

64 general practices in England.

PARTICIPANTS:

579 patients with chronic or recurrent low back pain; 144 were randomised to normal care, 147 to massage, 144 to six Alexander technique lessons, and 144 to 24 Alexander technique lessons; half of each of these groups were randomised to exercise prescription.

INTERVENTIONS:

Normal care (control), six sessions of massage, six or 24 lessons on the Alexander technique, and prescription for exercise from a doctor with nurse delivered behavioural counselling.

MAIN OUTCOME MEASURES:

Roland Morris disability score (number of activities impaired by pain) and number of days in pain.

RESULTS:

Exercise and lessons in the Alexander technique, but not massage, remained effective at one year (compared with control Roland disability score 8.1: massage -0.58, 95% confidence interval -1.94 to 0.77, six lessons -1.40, -2.77 to -0.03, 24 lessons -3.4, -4.76 to -2.03, and exercise -1.29, -2.25 to -0.34). Exercise after six lessons achieved 72% of the effect of 24 lessons alone (Roland disability score -2.98 and -4.14, respectively). Number of days with back pain in the past four weeks was lower after lessons (compared with control median 21 days: 24 lessons -18, six lessons -10, massage -7) and quality of life improved significantly. No significant harms were reported.

CONCLUSIONS:

One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons. Trial registration: National Research Register N0028108728.

Comment in

Republished in

PMID: 18713809

[PubMed - indexed for MEDLINE]

Free full text

 

21. Complementary and alternative medicine in back pain utilization report.

Santaguida PL, Gross A, Busse J, Gagnier J, Walker K, Bhandari M, Raina P.

http://www.ncbi.nlm.nih.gov/pubmed/20629474

 

Abstract

OBJECTIVES:

This systematic review was undertaken to evaluate which complementary and alternative medicine (CAM) therapies are being used for persons with back pain in the United States.

DATA SOURCES:

MEDLINE, CINHAHL, EMBASE, and Cochrane Central, and a variety of CAM specific databases were searched from 1990 to November 2007. A grey literature search was also undertaken, particularly for clinical practice guidelines (CPG) related to CAM.

REVIEW METHODS:

Standard systematic review methodology was employed. Eligibility criteria included English studies of adults with back pain, and a predefined list of CAM therapies.

RESULTS:

A total of 103 publications were evaluated; of these 29 did not present CAM therapy use stratified for back pain. There were a total of 65 utilization studies, 43 of which were American. Four publications evaluated the concurrent use of four or more CAM therapies and these suggest that chiropractic/manipulation is the most frequently used modality followed by massage and acupuncture. A limited number of publications evaluated utilization rates within multiple regions of the back and show that CAM was used least for treating the thoracic spine and most for the low back. However, rates of the use of massage were similar for neck and lower back regions. Concurrent use of different CAM or conventional therapies was not well reported. From 11 eligible CPG, only one (for electro-acupuncture) provided recommendations for frequency of use for low back pain of all acuity levels. Eighteen cost publications were reviewed and all but one publication (cost-effectiveness) were cost identification studies. There is limited information on the impact of insurance coverage on costs and utilization specific to back pain.

CONCLUSIONS:

There are a few studies evaluating the relative utilization of various CAM therapies for back pain. For those studies evaluating utilization of individual CAM therapies, the specific characteristics of the therapy, the providers, and the clinical presentation of the back pain patients were not adequately detailed; nor was the overlap with other CAM or conventional treatments.

PMID: 20629474

[PubMed - indexed for MEDLINE]

 

22. Comparative study on Chinese medicine and western medicine for treatment of osteoarthritis of the knee in Caucasian patients.

[Article in Chinese]

Qin XY, Li XX, Berghea F, Suteanu S.

http://www.ncbi.nlm.nih.gov/pubmed/18630549

 

Source

Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Abstract

OBJECTIVE:

To compare the efficacy, safety and tolerability of different therapies in Caucasian patients with osteoarthritis (QA) of the knee.

METHODS:

Seventy-five cases (90 knee joints) of osteoarthritis were randomly divided into 3 groups, western medicine group, traditional Chinese medicine (TCM) group, integrated Chinese and western medicine group. The western medicine group were treated with oral administration of Glucosamine Sulfate, oral administration and external application of non-steroid anti-inflammatory agent, ultrasound physiotherapy, etc. The TCM group were treated with oral administration of J uanbi Decoction, acupuncture and moxibustion, cupping, massage of acupoint and ear acupuncture. The integrated Chinese and western medicine group were treated with oral administration of Glucosamine Sulfate, oral administration and external application of non-steroid anti-inflammatory agent, acupuncture and moxibustion, cupping, massage of acupoint and ear acupuncture. The intensity of knee joint pain on walking, resting and standing, the nocturnal pain, stiffness, the maximum walking distance and the daily living ability were monitored after 30 days, 60 days and 90 days of treatment.

RESULTS:

After 90 days of treatment, the integrated Chinese and western medicine group was better than other two groups in improvement of percentages in self pain assessment with visual analog scale (VAS), pain and stiffness measured by WOMAC scale, pain and maximum walking distance measured by Lequesne scale (P < 0.05 or P < 0.01). There were no significant differences in the therapeutic effects between the TCM group and the western medicine group. All of these three treatments were well tolerated, and no severe adverse events were found.

CONCLUSION:

Combined TCM and western medicine treatment has rapid and definite therapeutic effect in reducing pain and improving mobility of knee joints and daily living ability in Caucasian patients of knee osteoarthritis.

PMID: 18630549

[PubMed - indexed for MEDLINE]

 

23. Surgery for chronic Achilles tendinopathy produces worse results in women.

Maffulli N, Testa V, Capasso G, Oliva F, Panni AS, Longo UG, King JB.

http://www.ncbi.nlm.nih.gov/pubmed/18608368

 

Source

Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke on Trent, UK.

Abstract

PURPOSE:

To report the middle term outcome in male and female patients who underwent surgery for chronic recalcitrant Achilles tendinopathy.

METHODS:

We tried to match each of the 58 female patients with a diagnosis of tendinopathy of the main body of the Achilles tendon with a male patient with tendinopathy of the main body of the Achilles tendon who was within two years of age at the time of operation. A match accordingly was possible for 41 female subjects.

RESULTS:

Female patients were shorter and lighter than male patients. They had similar BMI, lower calf circumference, similar side-to-side calf circumference differences, and greater subcutaneous body fat than men. Of the 41 sedentary patients, only 25 reported an excellent or good result. Of these, three had undergone a further exploration of the Achilles tendon. The remaining patients could not return to their normal levels of activity despite prolonged supervised post-operative physiotherapy, with cryotherapy, massage, ultrasound, pulsed magnetic, and laser therapy.

CONCLUSION:

Females experience more prolonged recovery, more complications, and a greater risk of further surgery than males with recalcitrant Achilles tendinopathy.

PMID: 18608368

[PubMed - indexed for MEDLINE]

 

24. An experimental study on the effectiveness of massage with aromatic ginger and orange essential oil for moderate-to-severe knee pain among the elderly in Hong Kong.

Yip YB, Tam AC.

http://www.ncbi.nlm.nih.gov/pubmed/18534325

Source

yipvera@gmail.com <yipvera@gmail.com>

Abstract

OBJECTIVES:

To assess the efficacy of an aromatic essential oil (1% Zingiber officinale and 0.5% Citrus sinesis) massage among the elderly with moderate-to-severe knee pain.

METHOD:

Fifty-nine older persons were enrolled in a double-blind, placebo-controlled experimental study group from the Community Centre for Senior Citizens, Hong Kong. The intervention was six massage sessions with ginger and orange oil over a 3-week period. The placebo control group received the same massage intervention with olive oil only and the control group received no massage. Assessment was done at baseline, post 1-week and post 4 weeks after treatment. Changes from baseline to the end of treatment were assessed on knee pain intensity, stiffness level and physical functioning (by Western Ontario and McMaster Universities Osteoarthritis index) and quality of life (by SF-36).

RESULTS:

There were significant mean changes between the three time-points within the intervention group on three of the outcome measures: knee pain intensity (p=0.02); stiffness level (p=0.03); and enhancing physical function (p=0.04) but these were not apparent with the between-groups comparison (p=0.48, 0.14 and 0.45 respectively) 4 weeks after the massage. The improvement of physical function and pain were superior in the intervention group compared with both the placebo and the control group at post 1-week time (both p=0.03) but not sustained at post 4 weeks (p=0.45 and 0.29). The changes in quality of life were not statistically significant for all three groups.

CONCLUSION:

The aroma-massage therapy seems to have potential as an alternative method for short-term knee pain relief.

PMID: 18534325

[PubMed - indexed for MEDLINE]

 

25. How do parents of children with juvenile idiopathic arthritis (JIA) perceive their therapies?

Rouster-Stevens K, Nageswaran S, Arcury TA, Kemper KJ.

Source

Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA. krouster@wfubmc.edu

Abstract

BACKGROUND:

Complementary and alternative medical (CAM) therapies are commonly used by pediatric patients with chronic medical conditions. Little is known about parents' perceptions of these therapies. This study describes the views of parents of patients with juvenile idiopathic arthritis (JIA) regarding conventional and CAM therapies.

METHODS:

Parents of children with JIA seen at a pediatric rheumatology clinic were surveyed between June 1 and July 31, 2007. Questionnaires asked about patients' use of over 75 therapies in the past 30 days, their perceived helpfulness (0 = not helpful; 3 = very helpful), perceived side effects (0 = none; 3 = severe), and whether each therapy would be recommended to other patients with JIA (Yes, No, Not sure).

RESULTS:

Questionnaires were returned by 52/76 (68%) parents; patients' average age was 10.9 years and 87% were Caucasian. Medications were used by 45 (88%) patients; heat (67%) and extra rest (54%) were also commonly used. CAM therapies were used by 48 (92%), e.g., massage (54%), vitamins and other supplements (54%), avoiding foods that worsened pain (35%) and stress management techniques (33%). Among the therapies rated by 3 or more parents, those that scored 2.5 or higher on helpfulness were: biologic medications, methotrexate, naproxen, wheelchairs, orthotics, heat, vitamins C and D, music, support groups and prayer. CAM therapies had 0 median side effects and parents would recommend many of them to other families.

CONCLUSION:

JIA patients use diverse therapies. Parents report that many CAM therapies are helpful and would recommend them to other parents. These data can be used in counseling patients and guiding future research.

PMID: 18518962

[PubMed - indexed for MEDLINE]

PMCID: PMC2424030

Free PMC Article

 

26. The benefit of nonpharmacologic therapy to treat symptomatic osteoarthritis.

Lee YC, Shmerling RH.

http://www.ncbi.nlm.nih.gov/pubmed/18457605

 

Source

Division of Rheumatology, Immunology and Allergy, Robert Breck Brigham Arthritis Center, 45 Francis Street, Boston, MA 02115, USA. ylee9@partners.org

Abstract

Osteoarthritis affects a large proportion of the population, especially the elderly, leading to pain and disability. To relieve pain, many patients are turning toward nonpharmacologic therapies. Conventional nonpharmacologic treatments such as weight loss and exercise are well accepted by the medical community, and some randomized controlled trials support the use of these treatments in patients with knee osteoarthritis. However, little information exists regarding the efficacy of these treatments for osteoarthritis at other sites. Less conventional treatments such as acupuncture and massage are emerging as promising options for osteoarthritis treatment, but the magnitude of benefit has varied between studies. More investigation is necessary to reach a conclusion regarding the efficacy of these treatments.

PMID: 18457605

[PubMed - indexed for MEDLINE]

 

27. Complementary therapies in the management of low back pain: a survey of reflexologists.

Quinn F, Baxter GD, Hughes CM.

http://www.ncbi.nlm.nih.gov/pubmed/18346623

 

Source

Health and Rehabilitation Sciences Research Institute, University of Ulster, Shore Road, Newtownabbey, Co. Antrim BT370QB, United Kingdom.

Abstract

OBJECTIVE:

To investigate current management of low back pain (LBP) by reflexologists.

METHODS:

A postal survey of reflexologists (n=500) sampled from the International Institute of Reflexology. The questionnaire used investigated a range of areas including: professional details, reflexology training and practice, views and experiences of reflexology, reflexology and LBP, and views on other complementary therapies.

RESULTS:

Response rate was 49.6% (n=248). The majority of respondents were female (95%), and were primarily employed within another profession such as nursing or teaching. Respondents perceived reflexology to have a positive effect on relieving LBP (94.3%) and to provide more benefit than simply relaxation. Practitioners also commented on other treatment effects, e.g. improving sleep patterns, decreasing anxiety and stress. It was reported that other healthcare practitioners, including general practitioners, referred patients to reflexologists for treatment.

DISCUSSION:

Respondents considered reflexology to be an effective therapy for LBP. Further work is warranted to investigate the potential role of such treatment in the management of this prevalent and intractable condition.

PMID: 18346623

[PubMed - indexed for MEDLINE]

 

28. Complementary/alternative medicine use among chronic pain clinic patients.

Konvicka JJ, Meyer TA, McDavid AJ, Roberson CR.

http://www.ncbi.nlm.nih.gov/pubmed/18226781

 

Source

Department of Anesthesiology, Scott & White Memorial Hospital and Clinic, 2401 S. 31st St, Temple, TX 76508, USA.

Abstract

Complementary and alternative therapies have enjoyed increasingly widespread use in recent years. Because of this trend, we were eager to obtain a better grasp on the actual number of people in our hospital's pain clinic who have used these modalities. In an effort to explore the use of complementary/alternative medicine (CAM) by patients seen in an anesthesiology chronic pain clinic, we conducted a study using a questionnaire. This questionnaire contained two sections, one covering complementary/alternative modalities and the other dealing with herbals or nutraceuticals. More than 400 patients were surveyed, 41% of whom were male and 59% of whom were female. Comparing alternative therapies by gender revealed no statistical difference in males versus females. The most commonly chosen modalities overall were nutraceuticals, massage therapy, and acupuncture. In terms of age, we found that the patients surveyed who were older than 60 years of age preferred nutraceuticals, and that the younger age group preferred more interactive relaxation techniques, such as meditation and massage.

PMID: 18226781

[PubMed - indexed for MEDLINE]

 

29. Use of complementary alternative medicine for low back pain consulting in general practice: a cohort study.

Chenot JF, Becker A, Leonhardt C, Keller S, Donner-Banzhoff N, Baum E, Pfingsten M, Hildebrandt J, Basler HD, Kochen MM.

http://www.ncbi.nlm.nih.gov/pubmed/18088435

 

Source

Dpt. of General Practice, University of Göttingen, Humboldtallee 38, 37073 Göttingen, Germany. jchenot@gwdg.de

Abstract

BACKGROUND:

Although back pain is considered one of the most frequent reasons why patients seek complementary and alternative medical (CAM) therapies little is known on the extent patients are actually using CAM for back pain.

METHODS:

This is a post hoc analysis of a longitudinal prospective cohort study embedded in a RCT. General practitioners (GPs) recruited consecutively adult patients presenting with LBP. Data on physical function, on subjective mood, and on utilization of health services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months

RESULTS:

A total of 691 (51%) respectively 928 (69%) out of 1,342 patients received one form of CAM depending on the definition. Local heat, massage, and spinal manipulation were the forms of CAM most commonly offered. Using CAM was associated with specialist care, chronic LBP and treatment in a rehabilitation facility. Receiving spinal manipulation, acupuncture or TENS was associated with consulting a GP providing these services. Apart from chronicity disease related factors like functional capacity or pain only showed weak or no association with receiving CAM.

CONCLUSION:

The frequent use of CAM for LBP demonstrates that CAM is popular in patients and doctors alike. The observed association with a treatment in a rehabilitation facility or with specialist consultations rather reflects professional preferences of the physicians than a clear medical indication. The observed dependence on providers and provider related services, as well as a significant proportion receiving CAM that did not meet the so far established selection criteria suggests some arbitrary use of CAM.

PMID: 18088435

[PubMed - indexed for MEDLINE]

PMCID: PMC2222227

Free PMC Article

 

30. Complementary and alternative medicine use for arthritis pain in 2 Chicago community areas.

Feinglass J, Lee C, Rogers M, Temple LM, Nelson C, Chang RW.

http://www.ncbi.nlm.nih.gov/pubmed/18075399

 

Source

Division of General Internal Medicine, Northwestern Feinberg School of Medicine, Chicago, IL 60611, USA. j-feinglass@northwestern.edu

Abstract

OBJECTIVE:

To compare the use of complementary and alternative medicine (CAM) for arthritis between 2 ethnically distinct metropolitan Chicago community areas.

METHODS:

A telephone interview survey of adults age 45 years or above living in North (88.9% white) or South (79.7% African American) areas. Of 763 respondents, 405 reported arthritis or chronic joint symptoms and were asked about use and satisfaction with 7 CAM therapies. Differences between areas were compared with population-weighted tests; multiple logistic regression was used to analyze the likelihood of CAM use controlled for demographics, behavioral risk factors, and arthritis severity.

RESULTS:

South Chicago respondents had a higher prevalence and more severe arthritis symptoms such as mean joint pain and more functional limitations. Use of CAM therapy by South Chicago respondents, most commonly massage and relaxation techniques, was 10% greater than North Chicago respondents (61.5% to 51%) but this was not significantly different. Among CAM users, South Chicago respondents reported higher satisfaction with 6 of the 7 CAM therapies and greater future interest in CAM therapies. Poor overall health status (P=0.03), arthritis pain (P=0.005), and concomitant use of prescription medications (P=0.03) were the only significant predictors of CAM use.

DISCUSSION:

Although there were only small differences in overall CAM use by area, older residents of largely African American communities were enthusiastic users of relaxation, massage, and nutritional and dietary techniques. CAM modalities could be important adjuncts to traditional medical treatment of arthritis pain for minority communities.

PMID: 18075399

[PubMed - indexed for MEDLINE]

 

31. When medication is not enough: nonpharmacologic management of pain.

Gatlin CG, Schulmeister L.

http://www.ncbi.nlm.nih.gov/pubmed/17962177

 

Source

Baton Rouge General in Louisiana, LA, USA. chris.gatlin@brgeneral.org

Abstract

Patients with cancer commonly experience pain, which typically is controlled pharmacologically. Despite advances in pain management, pain continues to be undertreated. Nonpharmacologic measures may effectively manage pain but often are overlooked or underused. Nurses who are familiar with simple, noninvasive, nonpharmacologic measures, such as patient positioning, thermal measures, massage therapy, aromatherapy, and mind-body therapies, can identify and educate patients who may benefit from nonpharmacologic interventions.

PMID: 17962177

[PubMed - indexed for MEDLINE]

 

32. Anthroposophic vs. conventional therapy for chronic low back pain: a prospective comparative study.

Hamre HJ, Witt CM, Glockmann A, Wegscheider K, Ziegler R, Willich SN, Kiene H.

http://www.ncbi.nlm.nih.gov/pubmed/17933703

 

Source

Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany. harald.hamre@ifaemm.de

Abstract

OBJECTIVE:

To compare anthroposophic treatment (eurythmy, rhythmical massage or art therapy; counselling, anthroposophic medication) and conventional treatment for low back pain (LBP) under routine conditions.

METHODS:

62 consecutive outpatients from 38 medical practices in Germany, consulting an anthroposophic (A-) or conventional (C-) physician with LBP of >or= 6 weeks duration participated in a prospective non-randomised comparative study. Main outcomes were Hanover Functional Ability Questionnaire (HFAQ), LBP Rating Scale Pain Score (LBPRS), Symptom Score, and SF-36 after 6 and 12 months.

RESULTS:

At baseline, LBP duration was > 6 months in 85% (29/34) of A-patients and 54% (15/28) of C-patients (p = 0.004). Unadjusted analysis showed significant improvements in both groups of HFAQ, LBPRS, Symptom Score, SF-36 Physical Component Summary, and three SF-36 scales (Physical Function, Pain, Vitality), and improvements in A-patients of three further SF-36 scales (Role Physical, General Health, Mental Health). After adjustment for age, gender, LBP duration, and education, improvements were still significant in both groups for Symptom Score (p = 0.030), SF-36 Physical Component Summary (p = 0.004), and three SF-36-scales (Physical Function, p = 0.025; Role Physical, p = 0.014; Pain, p = 0.003), and in A-patients for SF-36-Vitality (p = 0.032). Compared to C-patients, A-patients had significantly more pronounced improvements of three SF-36 scales (Mental Health: p = 0.045; General Health: p = 0.006; Vitality: p = 0.005); other improvements did not differ significantly between the two groups.

CONCLUSION:

Compared to conventional therapy, anthroposophic therapy for chronic LBP was associated with at least comparable improvements.

PMID: 17933703

[PubMed - indexed for MEDLINE]

 

33. Brief report: use of complementary and alternative medicine and psychological functioning in Latino children with juvenile idiopathic arthritis or arthralgia.

Zebracki K, Holzman K, Bitter KJ, Feehan K, Miller ML.

http://www.ncbi.nlm.nih.gov/pubmed/17626068

 

Source

Loyola University Chicago, Department of Psychology, IL 60626, USA. kzebrac@luc.edu

Abstract

OBJECTIVE:

To describe the use of complementary and alternative medicine (CAM) and its relationship to symptoms of anxiety, depression, and dysthymia in Latino children with juvenile idiopathic arthritis (JIA) or arthralgia.

METHODS:

Parents of 36 children between the ages of 6 and 16 years with either JIA (n = 17) or arthralgia (n = 19) completed questionnaires during routine pediatric rheumatology clinic visits assessing use of CAM and psychological functioning.

RESULTS:

CAM was used by the majority of children primarily to treat pain episodes. The most common modalities were prayer and massage therapy. CAM use was associated with decreased symptoms of anxiety and dysthymia in children with arthralgia, but not in children with JIA.

CONCLUSION:

Preliminary findings suggest that CAM use is associated with improved psychological functioning in children with arthralgia. Healthcare providers are encouraged to routinely screen for CAM usage and to educate families about the potential benefits and limitations of CAM.

PMID: 17626068

[PubMed - indexed for MEDLINE]

 

34. Non-pharmacological treatment of chronic widespread musculoskeletal pain.

Mannerkorpi K, Henriksson C.

http://www.ncbi.nlm.nih.gov/pubmed/17602997

 

Source

Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, Göteborg University, Guldhedsgatan 10, SE-413 46 Göteborg, Sweden. kaisa.mannerkorpi@rheuma.gu.se

Abstract

Non-pharmacological treatment for patients with chronic widespread pain (CWP) and fibromyalgia (FM) aims to enhance overall health. This chapter reviews studies of exercise, education, movement therapies and sensory stimulation. Based on a systematic review of randomized controlled trials (RCTs), we suggest that aerobic exercise of low to moderate intensity, such as walking and pool exercise, can improve symptoms and distress in patients with CWP and FM, and it may improve physical capacity in sedentary patients. Aerobic exercise of moderate to high intensity has been shown to improve aerobic capacity and tender-point status. Educational programmes have been shown to enhance self-efficacy and health perception. There is no conclusive evidence about the type of educational programme that works best, but a small-group format and interactive discussions appear to be important components. Exercise combined with education appears to produce synergies. Studies of movement therapies (such as qigong) and sensory treatments (such as acupuncture and massage) are few in number. There is today no conclusive evidence about the effects of these treatments in CWP, although positive effects have been reported in a few studies.

PMID: 17602997

[PubMed - indexed for MEDLINE]

 

35. CAM therapies among primary care patients using opioid therapy for chronic pain.

Fleming S, Rabago DP, Mundt MP, Fleming MF.

http://www.ncbi.nlm.nih.gov/pubmed/17506893

 

Source

Bastyr University, Seattle, Washington 98122, USA. sara.fleming@bastyr.edu

Abstract

BACKGROUND:

Complementary and alternative medicine (CAM) is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy.

METHOD:

A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population.

RESULTS:

Patients were treated for a variety of pain problems including low back pain (38.4%), headaches (9.9%), and knee pain (6.5%); the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248), chiropractic treatment (17.8%, n = 162), acupuncture (7.6%, n = 69), yoga (6.1%, n = 55), herbs and supplements (6.8%, n = 62), and prolotherapy (5.9%, n = 54). CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8%) and prolotherapy (87.7%), whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful.

CONCLUSION:

This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.

PMID: 17506893

[PubMed - indexed for MEDLINE]

PMCID: PMC1885447

Free PMC Article

 

36. Are SPA therapy and pulsed electromagnetic field therapy effective for chronic neck pain? Randomised clinical trial First part: clinical evaluation].

[Article in French]

Forestier R, Françon A, Saint-Arromand F, Bertolino C, Guillemot A, Graber-Duvernay B, Slikh M, Duplan B.

http://www.ncbi.nlm.nih.gov/pubmed/17229483

 

Source

Centre de recherche rhumatologique et thermal, BP 234, 73102 Aix-les-Bains cedex, France. romain.forestier@wanadoo.fr

Abstract

OBJECTIVES:

The purpose of this study was to compare SPA therapy (ST) with pulsed electromagnetic field (PEMF) therapy in chronic neck pain.

MATERIALS AND METHODS:

Inclusion criteria were age between 18 and 80 years, neck pain of more than 3 months' duration and pain score>30 mm on a visual analog scale (VAS). Exclusion criteria were contraindication to ST or PEMF. The protocol was approved by the ethics committee of Grenoble Hospital. Randomisation to the ST (n=44) and PEMF groups (n=42) was blinded. The main outcome measure was number of improved patients at 6 months in each group. A patient was considered improved if pain score decreased by more than 20%. Secondary measures were score on the Copenhagen and MOS SF-36 scales. Evaluation and intent-to-treat analysis were also blinded.

RESULTS:

Patients' preferences were for PEMF. At 6 months, in the PEMF group, 33 patients were improved, 5 not improved and 4 lost to follow-up. In the ST group, 24 patients were improved, 14 not improved and 6 lost to follow-up, for significantly greater improvement in the PEMF than ST group (p=0.02). Significant improvement was seen in both groups in terms of pain score, Copenhagen scale score and score on some dimensions of the MOS SF-36 survey.

CONCLUSION:

PEMF seems to be superior to standard ST without massage in control of neck pain. The difference between groups, although perhaps biased, seem to suggest the importance of our conclusions.

PMID: 17229483

[PubMed - indexed for MEDLINE]

 

37. Addition of choice of complementary therapies to usual care for acute low back pain: a randomized controlled trial.

Eisenberg DM, Post DE, Davis RB, Connelly MT, Legedza AT, Hrbek AL, Prosser LA, Buring JE, Inui TS, Cherkin DC.

http://www.ncbi.nlm.nih.gov/pubmed/17224808

 

Source

Division for Research and Education in Complementary and Integrative Medical Therapies, Osher Institute, Harvard Medical School, Boston, MA 02215, USA. david_eisenberg@hms.harvard.edu

Abstract

STUDY DESIGN:

A randomized controlled trial.

OBJECTIVE:

To investigate the effectiveness and cost of usual care plus patient choice of acupuncture, chiropractic, or massage therapy (choice) compared with usual care alone in patients with acute low back pain (LBP).

SUMMARY OF BACKGROUND DATA:

Few studies have evaluated care models with facilitated access to and financial coverage for adjunctive complementary and alternative medicine therapies.

METHODS:

A total of 444 patients with acute LBP (<21 days) were recruited from 4 clinical sites and randomized into 2 groups: usual care or choice. Outcomes included symptoms (bothersomeness), functional status (Roland), and satisfaction between baseline and 5 weeks, and cost of medical care in the 12 weeks after randomization.

RESULTS:

After 5 weeks, providing patients with a choice did not yield clinically important reductions in symptoms (median -4, [interquartile range -7, -2] for usual care, and -5 [-7, -3] for choice; P = 0.002) or improvements in functional status (-8 [-13, -2] for usual care, and -9 [-15, -4] for choice; P = 0.15). Although there was a significantly greater satisfaction with care in the choice group, this came at a net increase in costs of 244 dollars per patient. This consisted of a 99 dollars reduction in the average cost to the insurer for medical care but an additional cost of 343 dollars, for an average of 6.0 complementary and alternative medicine treatments per patient.

CONCLUSIONS:

A model of care that offered access to a choice of complementary and alternative medicine therapies for acute LBP did not result in clinically significant improvements in symptom relief or functional restoration. This model was associated with greater patient satisfaction but increased total costs. Future evaluations of this choice model should focus on patients with chronic conditions (including chronic back pain) for which conventional medical care is often costly and of limited benefit.

Comment in

PMID:17224808

[PubMed - indexed for MEDLINE]

 

38. The clinical effect of herbal magnetic corsets on lumbar disc herniation.

He C, Chen P, Wang X, Ding M, Lan Q, Han M.

http://www.ncbi.nlm.nih.gov/pubmed/17148517

 

Source

Rehabilitation Medical Center of West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.

Abstract

OBJECTIVE:

To determine the clinical effects of the treatment of lumbar disc herniation with herbal magnetic corsets.

DESIGN:

A randomized control trial.

SETTING:

The outpatient and inpatient departments of the Rehabilitation Center of the West China Hospital.

PATIENTS:

Sixty patients with clinically diagnosed lumbar disc herniation were included in the study.

INTERVENTIONS:

Both groups received lumbar traction, medium frequency electrotherapy and massage, whereas the experimental group wore herbal magnetic corsets in addition.

MAIN OUTCOME MEASURES:

Pain and lumbar function were assessed before treatment and at one week, two weeks and four weeks after intervention.

RESULTS:

Both groups reported improvements in pain and lumbar function after treatment (P 0.05 or P 0.001). However, the experimental group reported gradually increasing relief over time leading to a better curative effect than observed in the control group (P 0.05 for visual analogue scale or P 0.001 for lumbar function).

CONCLUSION:

Herbal magnetic corsets can facilitate the reduction of pain caused by lumbar disc herniation and can improve lumbar function. This is a safe and effective non-operative therapeutic option for treatment of lumbar disc herniation.

PMID: 17148517

[PubMed - indexed for MEDLINE]

 

39. Why do patients with rheumatoid arthritis use complementary therapies?

Rose G.

http://www.ncbi.nlm.nih.gov/pubmed/17042021

 

Source

Rheumatology Department, Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK. Ginny.Rose@ipswichhospital.nhs.uk

Abstract

OBJECTIVES:

(1) to develop an understanding as to how the use of complementary therapy (CT) affects a patient's perspective of health and well-being, (2) to offer the rheumatology professional insight and understanding as to why a patient chooses to use a CT, and (3) to raise awareness as to the forms of CT most commonly used by patients with rheumatoid arthritis.

METHODS:

This qualitative study was based on phenomenological principles applied through focused inquiry to develop an understanding of the lived experience of the study participants. The inclusion criteria of an established diagnosis of rheumatoid arthritis and known use of CT were applied to a convenience sample of patients attending a rheumatology outpatient department clinic on two consecutive days. Of the 15 eligible patients identified, five were randomly selected for inclusion in the study. Narrative data were collected through analysis of transcripts taken from audiotape recordings of unstructured interviews with study participants. A manual indexing system was used to develop four significant categorisation themes to reflect the findings: (1) incentives to use CT, (2) perceived benefits of CT use, (3) the choice of CT used, and (4) perceived disadvantages and risks of CT use.

RESULTS:

Incentives to use CT included dissatisfaction with conventional treatment, often in the form of side effects, and drug ineffectiveness. Social factors, such as loss of employment and social activities, were also indicated, as were psychological changes in the form of depression, hopelessness and fear. Perceived benefits were categorised as either physical or psychological with associated aspects of choice and control viewed as important elements of personal empowerment. The choice of CT used fell into three categories; physical, spiritual and herbal. The most commonly used of these were herbal remedies and supplements, closely followed by aromatherapy massage. Disadvantages and risks were identified as physical (pain and discomfort), psychological (fear and uncertainty), and/or material (cost).

CONCLUSIONS:

This study suggests that regular use of CT by patients with rheumatoid arthritis offers holistic benefits. Compared to conventional treatments, CT is seen to have advantages in terms of a lower incidence of adverse reactions, greater patient choice, psychological comfort and an increased quality of the patient/therapist relationship. The use of CT by patients with rheumatoid arthritis indicates a need for evidence-based information about its use and safety in order to direct practice within a rheumatology department.

Copyright 2006 John Wiley & Sons, Ltd.

PMID: 17042021

[PubMed - indexed for MEDLINE]

 

40. Complementary medicine in rheumatoid arthritis.

[Article in Italian]

Sarzi-Puttini P, Atzeni F, Lubrano E.

http://www.ncbi.nlm.nih.gov/pubmed/16380748

 

Source

Unità di Reumatologia, Università Ospedale L. Sacco, Via G.B. Grassi 74, 20157 Milano, Italia. sarzi@tiscali.it.

Abstract

Use of complementary and alternative medicine (CAM) for chronic conditions has increased in recent years. CAM is immensely popular for musculoskeletal conditions and patients suffering from rheumatoid arthritis (RA) frequently try CAM. This review summarises the trial data for or against CAM as a symptomatic treatment for rheumatoid arthritis. Collectively the evidence demonstrates that some CAM modalities show significant promise, e.g. acupuncture, diets, herbal medicine, homoeopathy, massage, supplements. However, for the great majority of these therapies no evidencebased (clinical randomised trials) results are available. CAM is usually used in addition to, and not as a substitute for conventional therapies. The motivation of patients to try CAM is complex; the willingness to take control of their healthcare, the desire to try everything available, the mass-media pressure and the erroneous notion that CAM is without risks. In fact, none of these treatments is totally devoid of risks. While the use of complementary and alternative modalities for the treatment of RA continues to increase, rigorous clinical trials examining their efficacy are needed before definitive recommendations regarding the application of these modalities can be made.

PMID: 16380748

[PubMed - indexed for MEDLINE]

Free full text

 

41. Preliminary evidence of the short-term effectiveness of alternative treatments for low back pain.

Davis KG, Kotowski SE.

http://www.ncbi.nlm.nih.gov/pubmed/16340089

 

Source

Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA. kermit.davis@uc.edu

Abstract

In recent years, there has been increased popularity for use of alternative treatment modalities for low back pain with limited investigation into whether they are effective in returning the worker to normal functionality. The objective of this study was to investigate the short-term impact on the restoration of the functional ability of common treatment modalities including physical therapy, acupuncture, chiropractic treatment, and massage therapy. A within subjects design was used that compared a baseline assessment to three follow-up assessments: immediately following treatment, two days and seven days post treatment. Individuals suffering from low back pain were recruited from local clinics that specialize in one of the four treatment modalities. Twenty-four individuals who were suffering from low back pain and had started one of the treatment modalities were recruited into the study. Three-dimensional motions (ROM, velocity, and acceleration) during a standardized functional capacity protocol were measured prior to and during three follow-up periods. The results show the effectiveness of the treatments was dependent upon time and were predominantly in the non-sagittal motion planes (velocities and accelerations). Individual subjective pain levels also indicate all the treatment modalities were effective after the 1-week follow-up. Findings suggest those modalities primarily focused on the back musculature (acupuncture, massage, physical therapy) were more effective with respect to functional capacity restoration. The current results provide a quantitative evaluation, based upon trunk dynamics, of the effectiveness of these four treatment modalities.

PMID: 16340089

[PubMed - indexed for MEDLINE]

 

42.Complementary and alternative medicine for low-back pain in pregnancy: a cross-sectional survey.

Wang SM, DeZinno P, Fermo L, William K, Caldwell-Andrews AA, Bravemen F, Kain ZN.

http://www.ncbi.nlm.nih.gov/pubmed/15992230

 

Source

Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06518, USA. shu-ming.wang@yale.edu

Abstract

OBJECTIVE:

To identify common treatments used for low-back pain (LBP) during pregnancy.

DESIGN:

A two-part anonymous survey.

SETTING/LOCATION:

New Haven, Connecticut.

SUBJECTS:

Pregnant women and providers of prenatal health care (nurse educators, nurse midwives, and obstetricians).

RESULTS:

We found that the majority of pregnant women who participated in our survey (61.7%) reported that they would accept complementary and alternative medicine (CAM) therapy as treatment for LBP during pregnancy. Similarly, 61% of providers of prenatal health care in our sample reported that they would consider using CAM as treatment for LBP during pregnancy. Massage (61.4%), acupuncture (44.6%), relaxation (42.6%), yoga (40.6%), and chiropractic (36.6%) were the most common CAM therapies recommended for LBP in pregnancy by the providers of prenatal health care in our sample.

CONCLUSIONS:

This two-part survey study found that both providers of prenatal health care and pregnant women in New Haven county are likely to use CAM treatments for pregnancy-induced LBP. Further investigation should focus on whether it is a nationwide phenomenon, as well as if various CAM therapies are an efficacious treatment for LBP during pregnancy.

PMID: 15992230

[PubMed - indexed for MEDLINE]

 

43. Complementary and alternative therapies for low back pain.

van Tulder MW, Furlan AD, Gagnier JJ.

http://www.ncbi.nlm.nih.gov/pubmed/15949781

 

Source

Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. mw.vantulder@vumc.nl

Abstract

The support for the principles of evidence-based medicine has increased within the field of complementary and alternative medicine (CAM). The objective of this chapter is to determine the effectiveness of CAM therapies compared to placebo, no intervention, or other interventions for acute/subacute and chronic non-specific low back pain (LBP). Results from Cochrane reviews on acupuncture, botanical medicine, massage, neuroreflexotherapy, and spinal manipulation have been used. The results showed that acupuncture is more effective than no treatment or sham treatment for chronic LBP but that there are no differences in effectiveness compared with other conventional therapies. Specific botanical medicines can be effective for acute episodes of chronic non-specific LBP in terms of short-term improvement in pain and functional status; long-term efficacy was not assessed. Massage seems more beneficial than sham treatment for chronic non-specific LBP but effectiveness compared with other conventional therapies is inconclusive. Neuroreflexotherapy appears to be more effective than sham treatment or standard care for chronic non-specific LBP. Spinal manipulation was more effective than sham manipulation or ineffective therapies, and equally effective as other conventional therapies. In summary, the results on CAM therapies for (acute episodes of) chronic LBP are promising but more evidence on the relative cost-effectiveness compared to conventional treatments is needed.

PMID: 15949781

[PubMed - indexed for MEDLINE]

 

44. Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty.

Pellino TA, Gordon DB, Engelke ZK, Busse KL, Collins MA, Silver CE, Norcross NJ.

http://www.ncbi.nlm.nih.gov/pubmed/15928526

 

Source

University of Wisconsin Hospitals & Clinics, Madison, WI, USA.

Abstract

PURPOSE:

The purpose of this study was to compare pain and anxiety in orthopaedic patients scheduled for elective total hip or knee arthroplasty who have received a kit of nonpharmacologic strategies for pain and anxiety in addition to their regularly prescribed analgesics to those who receive the usual pharmacologic management alone.

DESIGN:

Descriptive comparative and correlational design using surveys and chart audits.

SAMPLE:

Sixty-five patients randomized to receive usual care or usual care plus a kit of nonpharmacologic strategies.

FINDINGS:

Patients who received the kit used nonpharmacologic measures for pain and anxiety more often than patients who did not receive the kit. The kit group tended to use less opioid and have less anxiety on postoperative day 1 (not statistically significant) and use significantly less opioid on postoperative day 2 than the patients who did not receive the kit. There were no between-group differences in pain intensity. There were significant correlations among postoperative pain intensity, opioid use, and anxiety. The coping method of diverting attention was related to lower present (now) pain scores, and ignoring the pain was associated with higher worst pain.

DISCUSSION:

Providing a kit of nonpharmacologic strategies can increase the use of these methods for postoperative pain and anxiety and decrease the amount of opioid taken. The influence of coping strategies in acute postoperative pain needs to be examined further.

PMID:15928526

[PubMed - indexed for MEDLINE]

 

45. Non-pharmacological pain-relieving therapies in individuals with spinal cord injury: a patient perspective.

Norrbrink Budh C, Lundeberg T.

http://www.ncbi.nlm.nih.gov/pubmed/15649832

 

Source

Spinalis SCI unit, Karolinska University Hospital, SE-169 89 Stockholm, Sweden. cecilia.budh@spinalis.se

Abstract

OBJECTIVE:

To assess the non-pharmacological treatments used and preferred by patients with spinal cord injury and pain.

DESIGN:

A cross-sectional descriptive study.

INTERVENTIONS:

One hundred and twenty three patients with spinal cord injury, matched for gender, age, level of lesion and completeness of injury were assessed in 1999 at the Spinalis SCI unit, Stockholm, Sweden and followed-up in a mailed survey 3 years later. In total, 82.1% of the questionnaires (n=101) were returned. Ninety of these patients still suffered pain and were thus included in the study.

MAIN OUTCOME MEASURES:

Pain questionnaires, visual analogue scale (VAS), Hospital Anxiety and Depression Scale and Life Satisfaction instrument.

RESULTS:

63.3% of the patients had tried non-pharmacological treatments, where acupuncture, massage and transcutaneous electrical nerve stimulation (TENS) were the most commonly tried. Predictive for having tried non-pharmacological treatment were high ratings of pain intensity, presence of aching pain, and cutting/stabbing pain.

CONCLUSION:

Massage, and heat were the non-pharmacological treatments reported to result in the best pain alleviation. Results from our study suggest that we need to (re)evaluate the treatments offered to patients with spinal cord injury and pain and combine non-pharmacological and pharmacological treatments.

PMID: 15649832

[PubMed - indexed for MEDLINE]

 

46. Musculoskeletal conditions and complementary/alternative medicine.

Ernst E.

http://www.ncbi.nlm.nih.gov/pubmed/15301985

 

Source

Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, UK. edzard.ernst@pms.ac.uk

Abstract

Complementary/alternative medicine (CAM) is immensely popular for musculoskeletal conditions. It is, therefore, essential to define CAM's value for such indications. This chapter summarises the trial data for or against CAM as a symptomatic treatment for back pain, fibromyalgia, neck pain, osteoarthritis and rheumatoid arthritis. Collectively the evidence demonstrates that some CAM modalities show significant promise, e.g. acupuncture, diets, herbal medicine, homoeopathy, massage, supplements. None of the treatments in question is totally devoid of risks. By and large the data are not compelling, not least due to their paucity and methodological limitations. It is, therefore, concluded that our research efforts must be directed towards defining which form of CAM generates more good than harm for which condition.

PMID: 15301985

[PubMed - indexed for MEDLINE]

 

47. Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?

Sherman KJ, Cherkin DC, Connelly MT, Erro J, Savetsky JB, Davis RB, Eisenberg DM.

http://www.ncbi.nlm.nih.gov/pubmed/15260884

 

Source

Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA. Sherman.k@ghc.org

Abstract

BACKGROUND:

Although back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies.

METHODS:

We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months) of 70% of the patients with such diagnoses and all eligible respondents were interviewed.

RESULTS:

Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5-16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option.

CONCLUSIONS:

Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional studies evaluating their effectiveness and suggests that researchers conducting clinical trials of these therapies may not have difficulties recruiting patients.

PMID: 15260884

[PubMed - indexed for MEDLINE]

PMCID: PMC503394

Free PMC Article

 

48. Looking under every rock: Duchenne muscular dystrophy and traditional Chinese medicine.

Neuromuscul Disord. 2003 Nov;13(9):705-7.

Urtizberea JA, Fan QS, Vroom E, Récan D, Kaplan JC.

http://www.ncbi.nlm.nih.gov/pubmed/14561492

 

Source

Hôpital Raymond Poincaré, Garches, Université Versailles-, St Quentin, France. ja.urtizberea@wanadoo.fr

Abstract

Traditional Chinese medicine has been advocated to alleviate symptoms in Duchenne muscular dystrophy. To investigate this hypothesis, a pilot study was carried out in Beijing on 10 DMD boys treated with various regimens, including pills, decoctions, massages and acupuncture at various stages of their disease course. Despite the limited scientific impact of such a study, it seems as if the benefit, if any, is minimal. Moreover, some indirect clinical clues such as the cushingoid appearance found in a few patients suggest these drugs may also contain corticosteroids to some extent.

PMID: 14561492

[PubMed - indexed for MEDLINE]

 

49. Use of complementary and alternative medicine for temporomandibular disorders.

DeBar LL, Vuckovic N, Schneider J, Ritenbaugh C.

http://www.ncbi.nlm.nih.gov/pubmed/14520768

 

Source

Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, Oregon 97227, USA. lynn.debar@kpchr.org

Abstract

AIMS:

Despite many reports about complementary and alternative medicine (CAM) use in the general population, little information exists about specific CAM therapies used for particular health conditions. This study examines the use of CAM therapies among patients with temporomandibular disorders (TMD).

METHODS:

We surveyed 192 patients with documented TMD as part of a larger project on the effectiveness of various CAM modalities for TMD patients. The survey asked about use of and attitudes toward specific CAM therapies for treating TMD and other patient-identified health conditions. The survey also measured physical health, health behavior, and psychosocial functioning.

RESULTS:

Nearly two thirds of the respondents (62.5%; n = 120) reported using CAM therapies for TMD or a related condition. Of all the therapies reported, massage was rated as the most frequent and among the most satisfactory and helpful. In general, respondents who used CAM for their TMD reported being most satisfied with the "hands on" CAM therapies (massage, acupuncture, and chiropractic care). The vast majority of respondents reported using CAM approaches for TMD simultaneously with conventional care (95.6%; 66 of 69). Those using CAM for TMD tended to be older, had a history of multiple medical problems, and reported more positive psychologic functioning. Respondents who most often reported CAM treatment as "very helpful" for their TMD were likely to be healthier (i.e., reporting higher levels of exercise and fewer sleep disturbances).

CONCLUSION:

Given the frequent use of CAM treatments by our respondents, allopathic providers should inquire about the adjunctive use of CAM among their TMD patients.

PMID: 14520768

[PubMed - indexed for MEDLINE]