Complementary Health Approaches for Chronic Pain
The scientific evidence suggests that some complementary health approaches may help people manage chronic pain.
A comprehensive description of scientific research on all the complementary approaches that have been studied for chronic pain is beyond the scope of this fact sheet. This section highlights the research of some approaches used for common kinds of pain.
Chronic pain in general
Some recent research has looked at the effects of complementary approaches on chronic pain in general rather than on specific painful conditions.
- A 2014 evaluation of studies on active self-care complementary approaches (approaches that individuals can do themselves after being taught the technique) found that there is some evidence in favor of using yoga, tai chi, and music for self-management of chronic pain symptoms, but not enough to justify a strong recommendation for their use. The evidence is insufficient, according to this evaluation, to allow conclusions to be reached about other self-care approaches such as mindfulness/meditation, relaxation techniques, and qi gong.
- A 2016 evaluation of the research on mindfulness-based interventions found they may be helpful for patients with chronic pain, with effectiveness similar to that of cognitive-behavioral approaches.
- Research shows that hypnosis is moderately effective in managing chronic pain, when compared to usual medical care. However, the effectiveness of hypnosis can vary substantially from one person to another.
- There’s some evidence that cannabinoids (substances from marijuana) might be helpful for chronic neuropathic or cancer pain.
- A 2012 combined analysis of data from several studies concludes that acupuncture is a reasonable option to consider for chronic low-back pain. How acupuncture works to relieve pain is unclear. Current evidence suggests other factors—like expectation and belief—that are unrelated to acupuncture needling may play important roles in the beneficial effects of acupuncture on pain. A 2016 review of studies conducted in the United States found evidence that acupuncture can help some patients manage low-back pain.
- Massage might provide short-term relief from low-back pain, but the evidence is not of high quality. Massage has not been shown to have long-term benefits on low-back pain.
- There is some evidence that progressive relaxation may help relieve low-back pain, but studies on this topic have not been of the highest quality.
- Spinal manipulation appears to be as effective as other therapies commonly used for chronic low-back pain, such as physical therapy, exercise, and standard medical care.
- Studies have shown that yoga can be helpful for low-back pain in the short term and may also be helpful over longer periods of time.
- A 2014 evaluation of research on herbal products for low-back pain found preliminary evidence that devil’s claw and white willow bark, taken orally (by mouth), may be helpful for back pain. Cayenne, comfrey, Brazilian arnica, and lavender essential oilmay be helpful when used topically (applied to the skin).
- Studies of prolotherapy (a treatment involving repeated injections of irritant solutions) for low-back pain have had inconsistent results.
- A 2012 combined analysis of data from several studies indicated that acupuncture can be helpful and a reasonable option to consider for osteoarthritis pain. After that analysis was completed, a 2014 Australian study showed that both needle and laser acupuncture were modestly better than no treatment at relieving knee pain from osteoarthritis but not better than simulated (sham) laser acupuncture. These results generally agree with previous studies, which showed that acupuncture is consistently better than no treatment but not necessarily better than simulated acupuncture at relieving osteoarthritis pain.
- A small amount of research suggests that massage may help reduce osteoarthritis symptoms.
- Tai chi may improve pain in people with knee osteoarthritis. Qi gong may have similar benefits, but little research has been done on it.
- It’s uncertain whether yoga is helpful for osteoarthritis.
- Studies of glucosamine, chondroitin, and S-adenosyl-L-methionine (SAMe) for knee osteoarthritis pain have had conflicting results.
- There isn’t enough research on dimethyl sulfoxide (DMSO) or methylsulfonylmethane (MSM) for osteoarthritis pain to allow conclusions to be reached.
- The amount of research on mind and body practices for rheumatoid arthritis pain is too small for conclusions to be reached about their effectiveness.
- Dietary supplements containing omega-3 fatty acids, gamma-linolenic acid (GLA), or the herb thunder god vine may help relieve rheumatoid arthritis symptoms
- A 2012 combined analysis of data from several studies indicates that acupuncture can be helpful and a reasonable option to consider for headache pain. How acupuncture works to relieve pain is unclear. Current evidence suggests that many factors—like expectation and belief—that are unrelated to acupuncture needling may play important roles in the beneficial effects of acupuncture on pain.
- Because the evidence is limited or inconsistent, it’s uncertain whether biofeedback, massage, relaxation techniques, spinal manipulation, and tai chi are helpful for headaches.
- Guidelines from the American Academy of Neurology and the American Headache Society classify butterbur as effective; feverfew, magnesium, and riboflavin as probably effective; and coenzyme Q10 as possibly effective for preventing migraines.
- Acupuncture hasn’t been studied as extensively for neck pain as for some other conditions. A large study in Germany found that people who received acupuncture for neck pain had better pain relief than those who didn’t receive acupuncture. Several studies have compared actual acupuncture with simulated acupuncture, but the amount of research is limited. No current guidelines recommend acupuncture for neck pain.
- A 2016 review of studies performed in the United States found that massage therapy may provide short-term relief from neck pain, especially if massage sessions are relatively lengthy and frequent.
- Spinal manipulation may be helpful for neck pain.
- It’s uncertain whether acupuncture is helpful for fibromyalgia pain.
- Although some studies of tai chi, yoga, mindfulness, and biofeedback for fibromyalgia symptoms have had promising results, the evidence is too limited to allow definite conclusions to be reached about whether these approaches are helpful.
- There is insufficient evidence that any natural products can relieve fibromyalgia pain, with the possible exception of vitamin D supplements, which may reduce pain in people with fibromyalgia who have low vitamin D levels.
- Studies of homeopathy have not demonstrated that it is beneficial for fibromyalgia.