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Schmerz (Berlin, Germany)
Jun, 2023;37 (3): 215-227.

[Complementary and alternative medicine-An option for chronic pain patients?]

Jutta H��bner, Christian Keinki, Jens B��ntzel
Author Information
  1. Jutta H��bner: Klinik f��r Innere Medizin II, H��matologie und Internistische Onkologie, Universit��tsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland. jutta.huebner@med.uni-jena.de.
  2. Christian Keinki: Klinik f��r Innere Medizin II, H��matologie und Internistische Onkologie, Universit��tsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
  3. Jens B��ntzel: Klinik f��r Hals-Nasen-Ohren-Krankheiten, Abteilung f��r Palliativmedizin, S��dharzklinikum Nordhausen, Nordhausen, Deutschland.
PMID: 37154977 DOI: 10.1007/s00482-023-00719-4

Abstract

The interest of patients with chronic pain in complementary and alternative medicine (CAM) is high. The aim of an accompanying complementary therapy is to strengthen the patient's self-efficacy, the ability to make decisions and the autonomy. The best evidence exists for physical activity and a balanced diet. Exercise combinations of strength and endurance as well as targeted strengthening of the muscles in the area of the pain are particularly suitable. When choosing the form of exercise, low-threshold training options are recommended. There is no reliable evidence for kinesio taping, homeopathy, neural therapy and draining procedures. The extensive data on acupuncture must be interpreted taking methodological limitations into account. Heat applications can support multimodal pain therapy. In the case of anti-inflammatory phytotherapeutic agents, there are good rationales from basic research and reliable empirical knowledge regarding the dosage. The evidence on cannabis is low.

Keywords

Acupuncture Communication Exercise Multimodal pain therapy Phytotherapy

References

  1. H��sl A, Venkat S, Stein B et al (2021) Anwendung von Komplement��rmedizin bei chronischen Schmerzen. Schmerz 35:412���418. https://doi.org/10.1007/s00482-021-00546-5 [DOI: 10.1007/s00482-021-00546-5]
  2. Huebner J, Micke O, Muecke R et al (2014) User rate of complementary and alternative medicine (CAM) of patients visiting a counseling facility for CAM of a German comprehensive cancer center. Anticancer Res 34:943���948 [PMID: 24511037]
  3. Castellini G, Pillastrini P, Vanti C et al (2022) Some conservative interventions are more effective than others for people with chronic non-specific neck pain: a systematic review and network meta-analysis. J Physiother 68:244���254. https://doi.org/10.1016/j.jphys.2022.09.007 [DOI: 10.1016/j.jphys.2022.09.007]
  4. Geneen LJ, Moore RA, Clarke C et al (2017) Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD011279.pub3 [DOI: 10.1002/14651858.CD011279.pub3]
  5. Sipaviciene S, Kliziene I (2020) Effect of different exercise programs on non-specific chronic low back pain and disability in people who perform sedentary work. Clin Biomech 73:17���27. https://doi.org/10.1016/j.clinbiomech.2019.12.028 [DOI: 10.1016/j.clinbiomech.2019.12.028]
  6. Quentin C, Bagheri R, Ugbolue UC et al (2021) Effect of home exercise training in patients with nonspecific low-back pain: a systematic review and meta-analysis. Int J Environ Res Public Health 18:8430. https://doi.org/10.3390/ijerph18168430 [DOI: 10.3390/ijerph18168430]
  7. Tatikola SP, Natarajan V, Desai VK et al (2022) Effect of various exercise protocols on neuropathic pain in individuals with type 2 diabetes with peripheral neuropathy: A systematic review and meta-analysis. Diabetes Metab Syndr 16:102603. https://doi.org/10.1016/j.dsx.2022.102603 [DOI: 10.1016/j.dsx.2022.102603]
  8. Kumar S, Sharma VP, Negi MPS (2009) Efficacy of dynamic muscular stabilization techniques (DMST) over conventional techniques in rehabilitation of chronic low back pain. J Strength Cond Res 23:2651���2659. https://doi.org/10.1519/JSC.0b013e3181b3dde0 [DOI: 10.1519/JSC.0b013e3181b3dde0]
  9. Nduwimana I, Nindorera F, Thonnard JL, Kossi O (2020) Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials. Medicine 99:e21969. https://doi.org/10.1097/MD.0000000000021969 [DOI: 10.1097/MD.0000000000021969]
  10. Wells C, Kolt GS, Marshall P et al (2014) The effectiveness of Pilates exercise in people with chronic low back pain: a systematic review. Plos One 9:e100402. https://doi.org/10.1371/journal.pone.0100402 [DOI: 10.1371/journal.pone.0100402]
  11. Lauche R, Stumpe C, Fehr J et al (2016) The effects of tai chi and neck exercises in the treatment of chronic nonspecific neck pain: a randomized controlled trial. J Pain 17:1013���1027. https://doi.org/10.1016/j.jpain.2016.06.004 [DOI: 10.1016/j.jpain.2016.06.004]
  12. Giles LGF, Muller R (2003) Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine 28:1490���1502. https://doi.org/10.1097/00007632-200307150-00003 (discussion 1502���1503) [DOI: 10.1097/00007632-200307150-00003]
  13. Koes BW, Bouter LM, van Mameren H et al (1993) A randomized clinical trial of manual therapy and physiotherapy for persistent back and neck complaints: subgroup analysis and relationship between outcome measures. J Manipulative Physiol Ther 16:211���219 [PMID: 8340715]
  14. Licciardone JC, Minotti DE, Gatchel RJ et al (2013) Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med 11:122���129. https://doi.org/10.1370/afm.1468 [DOI: 10.1370/afm.1468]
  15. Pinheiro da Silva F, Moreira GM, Zomkowski K et al (2019) Manual therapy as treatment for chronic musculoskeletal pain in female breast cancer survivors: a systematic review and meta-analysis. J Manipulative Physiol Ther 42:503���513. https://doi.org/10.1016/j.jmpt.2018.12.007 [DOI: 10.1016/j.jmpt.2018.12.007]
  16. Michalsen A, Jeitler M, Kessler CS et al (2021) Yoga, eurythmy therapy and standard physiotherapy (YES-trial) for patients with chronic non-specific low back pain: a three-armed randomized controlled trial. J Pain 22:1233���1245. https://doi.org/10.1016/j.jpain.2021.03.154 [DOI: 10.1016/j.jpain.2021.03.154]
  17. Martinez-Calderon J, de-la-Casa-Almeida M, Matias-Soto J (2022) The effects of mind-body exercises on chronic spinal pain outcomes: a synthesis based on 72 meta-analyses. Int J Environ Res Public Health 19:12062. https://doi.org/10.3390/ijerph191912062 [DOI: 10.3390/ijerph191912062]
  18. Bai Z, Guan Z, Fan Y et al (2015) The effects of Qigong for adults with chronic pain: systematic review and meta-analysis. Am J Chin Med 43:1525���1539. https://doi.org/10.1142/S0192415X15500871 [DOI: 10.1142/S0192415X15500871]
  19. Cramer H, Klose P, Brinkhaus B et al (2017) Effects of yoga on chronic neck pain: a systematic review and meta-analysis. Clin Rehabil 31:1457���1465. https://doi.org/10.1177/0269215517698735 [DOI: 10.1177/0269215517698735]
  20. Zhu F, Zhang M, Wang D et al (2020) Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE 15:e238544. https://doi.org/10.1371/journal.pone.0238544 [DOI: 10.1371/journal.pone.0238544]
  21. Hall A, Copsey B, Richmond H et al (2017) Effectiveness of tai chi for chronic musculoskeletal pain conditions: updated systematic review and meta-analysis. Phys Ther 97:227���238. https://doi.org/10.2522/ptj.20160246 [DOI: 10.2522/ptj.20160246]
  22. Kong LJ, Lauche R, Klose P et al (2016) Tai chi for chronic pain conditions: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 6:25325. https://doi.org/10.1038/srep25325 [DOI: 10.1038/srep25325]
  23. Li Y, Li S, Jiang J, Yuan S (2019) Effects of yoga on patients with chronic nonspecific neck pain: a PRISMA systematic review and meta-analysis. Medicine 98:e14649. https://doi.org/10.1097/MD.0000000000014649 [DOI: 10.1097/MD.0000000000014649]
  24. Bl��dt S, Pach D, Kaster T et al (2015) Qigong versus exercise therapy for chronic low back pain in adults���a randomized controlled non-inferiority trial. Eur J Pain 19:123���131. https://doi.org/10.1002/ejp.529 [DOI: 10.1002/ejp.529]
  25. Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129���136. https://doi.org/10.1126/science.847460 [DOI: 10.1126/science.847460]
  26. Siddall PJ, Lovell M, MacLeod R (2015) Spirituality: what is its role in pain medicine? Pain Med 16:51���60. https://doi.org/10.1111/pme.12511 [DOI: 10.1111/pme.12511]
  27. Rettke H, Naef R, Rufer M, Peng-Keller S (2021) Spiritualit��t und Behandlung. Die Perspektive von Patienten mit chronischen Schmerzen. Schmerz 35:333���342. https://doi.org/10.1007/s00482-020-00524-3 [DOI: 10.1007/s00482-020-00524-3]
  28. Hasenfratz K, Moergeli H, Sprott H et al (2021) Do chronic pain patients wish spiritual aspects to be integrated in their medical treatment? A cross-sectional study of multiple facilities. Front Psychiatry 12:685158. https://doi.org/10.3389/fpsyt.2021.685158 [DOI: 10.3389/fpsyt.2021.685158]
  29. Luz J��nior MAD, Almeida MOD, Santos RS et al (2019) Effectiveness of Kinesio taping in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Spine 44:68���78. https://doi.org/10.1097/BRS.0000000000002756 [DOI: 10.1097/BRS.0000000000002756]
  30. Dogan M, Sahin O, Elden H et al (2011) Additional therapeutic effect of balneotherapy in low back pain. South Med J 104:574���578. https://doi.org/10.1097/SMJ.0b013e318224644f [DOI: 10.1097/SMJ.0b013e318224644f]
  31. Hall J, Skevington SM, Maddison PJ, Chapman K (1996) A randomized and controlled trial of hydrotherapy in rheumatoid arthritis. Arthritis Care Res 9:206���215. https://doi.org/10.1002/1529-0131(199606)9:3���206::aid-anr1790090309���3.0.co;2���j [DOI: 10.1002/1529-0131(199606)9]
  32. Kulisch A, Bender T, N��meth A, Szekeres L (2009) Effect of thermal water and adjunctive electrotherapy on chronic low back pain: a double-blind, randomized, follow-up study. J Rehabil Med 41:73���79. https://doi.org/10.2340/16501977-0291 [DOI: 10.2340/16501977-0291]
  33. Y��cesoy H, D��nmez A, Atmaca-Ayd��n E et al (2021) Effects of balneological outpatient treatment on clinical parameters and serum cytokine levels in patients with chronic low back pain: a single-blind randomized controlled trial. Int J Biometeorol 65:1367���1376. https://doi.org/10.1007/s00484-021-02109-w [DOI: 10.1007/s00484-021-02109-w]
  34. Freiwald J, Hoppe MW, Beermann W et al (2018) Effects of supplemental heat therapy in multimodal treated chronic low back pain patients on strength and flexibility. Clin Biomech 57:107���113. https://doi.org/10.1016/j.clinbiomech.2018.06.008 [DOI: 10.1016/j.clinbiomech.2018.06.008]
  35. Peres D, Sagawa Y, Dugu�� B et al (2017) The practice of physical activity and cryotherapy in rheumatoid arthritis: systematic review. Eur J Phys Rehabil Med 53:775���787. https://doi.org/10.23736/S1973-9087.16.04534-2 [DOI: 10.23736/S1973-9087.16.04534-2]
  36. Dantas LO, de Moreira RFC, Norde FM et al (2019) The effects of cryotherapy on pain and function in individuals with knee osteoarthritis: a systematic review of randomized controlled trials. Clin Rehabil 33:1310���1319. https://doi.org/10.1177/0269215519840406 [DOI: 10.1177/0269215519840406]
  37. Klemm P, Hoffmann J, Asendorf T et al (2022) Whole-body cryotherapy for the treatment of rheumatoid arthritis: a monocentric, single-blinded, randomised controlled trial. Clin Exp Rheumatol 40:2133���2140. https://doi.org/10.55563/clinexprheumatol/lrff6k [DOI: 10.55563/clinexprheumatol/lrff6k]
  38. Oltean H, Robbins C, van Tulder MW et al (2014) Herbal medicine for low-back pain. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD004504.pub4 [DOI: 10.1002/14651858.CD004504.pub4]
  39. Crawford C, Boyd C, Berry K et al (2019) Dietary ingredients requiring further research before evidence-based recommendations can be made for their use as an approach to mitigating pain. Pain Med 20:1619���1632. https://doi.org/10.1093/pm/pnz050 [DOI: 10.1093/pm/pnz050]
  40. Arora V, Campbell JN, Chung M���K (2021) Fight fire with fire: neurobiology of capsaicin-induced analgesia for chronic pain. Pharmacol Ther 220:107743. https://doi.org/10.1016/j.pharmthera.2020.107743 [DOI: 10.1016/j.pharmthera.2020.107743]
  41. Steinegger E, H��nsel R (1992) Pharmakognosie. Springer, Berlin, Heidelberg [DOI: 10.1007/978-3-662-09267-5]
  42. Boyd C, Crawford C, Berry K et al (2019) Conditional recommendations for specific dietary ingredients as an approach to chronic musculoskeletal pain: evidence-based decision aid for health care providers, participants, and policy makers. Pain Med 20:1430���1448. https://doi.org/10.1093/pm/pnz051 [DOI: 10.1093/pm/pnz051]
  43. Derry S, Moore RA (2012) Topical capsaicin (low concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD010111 [DOI: 10.1002/14651858.CD010111]
  44. Derry S, Rice AS, Cole P et al (2017) Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD007393.pub4 [DOI: 10.1002/14651858.CD007393.pub4]
  45. Goncalves D, Rebelo V, Barbosa P, Gomes A (2020) 8���% Capsaicin patch in treatment of peripheral neuropathic pain. Pain Phys 23:E541���E548 [DOI: 10.36076/ppj.2020/23/E541]
  46. Petzke F, Karst M, Gastmeier K et al (2019) Ein Positionspapier zu medizinischem Cannabis und cannabisbasierten Medikamenten in der Schmerzmedizin. Schmerz 33:449���465. https://doi.org/10.1007/s00482-019-00407-2 [DOI: 10.1007/s00482-019-00407-2]
  47. Dykukha I, Malessa R, Essner U, ��berall MA (2021) Nabiximols in chronic Neuropathic pain: a meta-analysis of randomized placebo-controlled trials. Pain Med 22:861���874. https://doi.org/10.1093/pm/pnab050 [DOI: 10.1093/pm/pnab050]
  48. Fisher E, Moore RA, Fogarty AE et al (2021) Cannabinoids, cannabis, and cannabis-based medicine for pain management: a systematic review of randomised controlled trials. Pain 162:S45���S66. https://doi.org/10.1097/j.pain.0000000000001929 [DOI: 10.1097/j.pain.0000000000001929]
  49. Sainsbury B, Bloxham J, Pour MH et al (2021) Efficacy of cannabis-based medications compared to placebo for the treatment of chronic neuropathic pain: a systematic review with meta-analysis. J Dent Anesth Pain Med 21:479���506. https://doi.org/10.17245/jdapm.2021.21.6.479 [DOI: 10.17245/jdapm.2021.21.6.479]
  50. M��cke M, Phillips T, Radbruch L et al (2018) Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD012182.pub2 [DOI: 10.1002/14651858.CD012182.pub2]
  51. Bialas P, Fitzcharles M���A, Klose P, H��user W (2022) Long-term observational studies with cannabis-based medicines for chronic non-cancer pain: a systematic review and meta-analysis of effectiveness and safety. Eur J Pain 26:1221���1233. https://doi.org/10.1002/ejp.1957 [DOI: 10.1002/ejp.1957]
  52. Noori A, Miroshnychenko A, Shergill Y et al (2021) Opioid-sparing effects of medical cannabis or cannabinoids for chronic pain: a systematic review and meta-analysis of randomised and observational studies. BMJ Open 11:e47717. https://doi.org/10.1136/bmjopen-2020-047717 [DOI: 10.1136/bmjopen-2020-047717]
  53. Wang L, Hong PJ, May C et al (2021) Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ 374:n1034. https://doi.org/10.1136/bmj.n1034 [DOI: 10.1136/bmj.n1034]
  54. Richards JR, Bing ML, Moulin AK et al (2019) Cannabis use and acute coronary syndrome. Clin Toxicol 57:831���841. https://doi.org/10.1080/15563650.2019.1601735 [DOI: 10.1080/15563650.2019.1601735]
  55. Richards JR, Blohm E, Toles KA et al (2020) The association of cannabis use and cardiac dysrhythmias: a systematic review. Clin Toxicol 58:861���869. https://doi.org/10.1080/15563650.2020.1743847 [DOI: 10.1080/15563650.2020.1743847]
  56. McDonagh MS, Wagner J, Ahmed AY et al (2021) Living systematic review on cannabis and other plant-based treatments for chronic pain. Agency for Healthcare Research and Quality (US), Rockville [DOI: 10.23970/AHRQEPCCER250]
  57. Y��lmaz E (2021) The determination of the efficacy of neural therapy in conservative treatment-resistant patients with chronic low back pain. Spine 46(6):E752���E759. https://doi.org/10.1097/BRS.0000000000003909 [DOI: 10.1097/BRS.0000000000003909]
  58. Chaoju X, Zhangyin S, Changchun JI, Jinsheng Y (2022) Efficacy and safety of blood pricking and cupping for treating nonspecific low back pain: a systematic review and Meta-analysis. J Tradit Chin Med 42:869���876. https://doi.org/10.19852/j.cnki.jtcm.20220922.003 [DOI: 10.19852/j.cnki.jtcm.20220922.003]
  59. Hohmann C���D, Stange R, Steckhan N et al (2018) The effectiveness of leech therapy in chronic low back pain. Dtsch Arztebl Int 115:785���792. https://doi.org/10.3238/arztebl.2018.0785 [DOI: 10.3238/arztebl.2018.0785]
  60. Paley CA, Johnson MI (2019) Acupuncture for the relief of chronic pain: a synthesis of systematic reviews. Medicina 56:6. https://doi.org/10.3390/medicina56010006 [DOI: 10.3390/medicina56010006]
  61. Jo H���R, Noh E���J, Oh S���H et al (2022) Comparative effectiveness of different acupuncture therapies for neck pain. Medicine 101:e29656. https://doi.org/10.1097/MD.0000000000029656 [DOI: 10.1097/MD.0000000000029656]
  62. Dong R, Chen X, Wu T, Liu GJ (2007) Elemene for the treatment of lung cancer. In: Cochrane Database of Systematic Reviews. The Cochrane Collaboration, John Wiley & Sons (CD006054.pub2)
  63. Hvistendahl M (2013) China���s publication bazaar. Science 342:1035���1039. https://doi.org/10.1126/science.342.6162.1035 [DOI: 10.1126/science.342.6162.1035]
  64. MacPherson H, Maschino AC, Lewith G et al (2013) Characteristics of acupuncture treatment associated with outcome: an individual patient meta-analysis of 17,922 patients with chronic pain in randomised controlled trials. Plos One 8:e77438. https://doi.org/10.1371/journal.pone.0077438 [DOI: 10.1371/journal.pone.0077438]
  65. Vickers AJ, Vertosick EA, Lewith G et al (2018) Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain 19:455���474. https://doi.org/10.1016/j.jpain.2017.11.005 [DOI: 10.1016/j.jpain.2017.11.005]
  66. Madsen MV, G��tzsche PC, Hr��bjartsson A (2009) Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ 338:a3115. https://doi.org/10.1136/bmj.a3115 [DOI: 10.1136/bmj.a3115]
  67. Xiang Y, He J���Y, Tian H���H et al (2020) Evidence of efficacy of acupuncture in the management of low back pain: a systematic review and meta-analysis of randomised placebo- or sham-controlled trials. Acupunct Med 38:15���24. https://doi.org/10.1136/acupmed-2017-011445 [DOI: 10.1136/acupmed-2017-011445]
  68. Xiang Y, He J, Li R (2018) Appropriateness of sham or placebo acupuncture for randomized controlled trials of acupuncture for nonspecific low back pain: a systematic review and meta-analysis. J Pain Res 11:83���94. https://doi.org/10.2147/JPR.S152743 [DOI: 10.2147/JPR.S152743]
  69. Cherkin DC, Eisenberg D, Sherman KJ et al (2001) Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch Intern Med 161:1081���1088. https://doi.org/10.1001/archinte.161.8.1081 [DOI: 10.1001/archinte.161.8.1081]
  70. Chen F���Q, Ge J���F, Leng Y���F et al (2020) Efficacy and safety of moxibustion for chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract 39:101130. https://doi.org/10.1016/j.ctcp.2020.101130 [DOI: 10.1016/j.ctcp.2020.101130]
  71. Beer AM, Fey S, Zimmer M et al (2012) Effectiveness and safety of a homeopathic drug combination in the treatment of chronic low back pain. A double-blind, randomized, placebo-controlled clinical trial. MMW Fortschr Med 154(Suppl 2):48���57. https://doi.org/10.1007/s15006-012-0304-z [DOI: 10.1007/s15006-012-0304-z]

MeSH Term

Humans
Chronic Pain
Complementary Therapies
Homeopathy
Acupuncture Therapy
English Abstract Journal Article

Word Cloud

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