Complementary and Alternative Medical Therapies
for Chronic Low Back Pain: What Treatments are Patients Willing to Try?
Sherman K, et al. Center for Health Studies, Group Health Cooperative, Seattle,
Washington 98101, USA , et al
Even though back pain is the most common reason patients use
complementary and alternative medical (CAM) therapies, very little is known
about the willingness of back pain patients to try these therapies. A study was
done 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.
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.
Acupuncture Compared with Massage and “Sham” Laser
Acupuncture for Treatment of Chronic Neck Pain
Dominik Irnich, et al. Department of Anaesthesiology, Ludwig-Maximilians University,
81377 Munich, Germany, et al
In order to compare the efficacy of acupuncture and
conventional massage for the treatment of chronic neck pain, a randomized,
placebo controlled trial was done with 177 patients aged 18-85 years old. The
patients were randomly given five treatments over three weeks with acupuncture
(56), massage (60), or “sham” laser acupuncture (61).
One week after five treatments the acupuncture group showed a
significantly greater improvement in motion related pain compared with massage
(difference 24.22 (95% confidence interval 16.5 to 31.9), P=0.0052) but not
compared with sham laser (17.28 (10.0 to 24.6), P=0.327). Differences between
acupuncture and massage or sham laser were greater in the subgroup who had had
pain for longer than five years (n=75) and in patients with myofascial pain
syndrome (n=129). The acupuncture group had the best results in most secondary
outcome measures. There were no differences in patients' beliefs in treatment.
The trial concluded that acupuncture is an effective
short-term treatment for chronic neck pain, but there is not enough evidence for
long-term relief after five treatments. Furthermore, compared with sham laser
acupuncture and massage, needle acupuncture increases mobility and relieves pain
related to motion in patients with chronic neck pain. Acupuncture was far more
effective than massage, but differences were not always significant compared
with sham laser acupuncture. Acupuncture was the best treatment for patients
with the myofascial syndrome and those who had had pain for longer than five
years
Electroacupuncture
versus Diclofenac for Osteoarthritis of
the Knee
Chaichan Sangdee, et al. Department of Pharmacology,
Faculty of Medicine, Chiang Mai University, Thailand., et al
In a study to compare the efficacy of electroacupuncture (EA),
diclofenac and their combination in symptomatic treatment of osteoarthritis (OA)
of the knee, a randomized, single blind, placebo controlled trial was performed
with 193 OA patients. The 193 patients were randomly separated into four groups:
placebo, diclofenac, EA and combined (diclofenac plus EA). Paracetamol tablets
were prescribed as a rescue analgesic during the study. 186 patients completed
the study and the results showed that EA is significantly more effective than
placebo and diclofenac in the symptomatic treatment of OA of the knee in some
circumstances. However, the combination of EA and diclofenac treatment was no
more effective than EA treatment alone.
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