Anesthesiologists and pain medicine specialists prescribe more opioid prescriptions than any other medical field. Many practitioners believe use of alternative medicine approaches such as acupuncture and yoga can help to fight the opioid epidemic.
“In the current opioid crisis era, many integrative medical therapies can be used as complements to mainstream medicine to address pain and reduce opioid abuse and addiction-related disease,” write Yuan-Chi Lin, M.D., M.P.H., and colleagues at Harvard Medical School.
In a special thematic issue of Anesthesia & Analgesia addressing the opioid crisis, they and other anesthesia and pain medicine physicians share evidence on this and other potentially effective strategies to reducing reliance on opioids to treat chronic and postoperative pain.
In the study, Lin and coauthors reviewed and analyzed current evidence on integrative medicine therapies — also called complementary and alternative medicine — for the treatment of pain.
“Integrative medicine for pain can play a major role in reducing the frequency and amount of opioid usage,” the researchers write.
The analysis included a total of 32 studies evaluating seven different types of integrative medicine therapies for pain. Acupuncture was the treatment showing the strongest evidence for effectiveness in reducing pain.
Overall there was “strong positive evidence” showing a beneficial effect of acupuncture for the treatment of chronic pain. There were also studies showing that acupuncture reduced the dose of opioids needed to control pain after surgery, with reduction in opioid-related side effects.
Most of the other therapies studied showed “positive preliminary evidence” of effectiveness in pain treatment. These included yoga, relaxation techniques (such as mindfulness meditation), tai chi, massage therapy, and spinal manipulation.
However, only a few of the studies addressed whether use of alternative therapies reduced the use of prescription medications in general or opioids in particular. There was conflicting evidence on the pain-reducing effectiveness of the supplements glucosamine and chondroitin for knee pain.
The authors acknowledge some important limitations of the current evidence on integrative therapies for pain. The studies in the review varied in terms of the methods used and the types of pain studied, in addition to the special challenges of studying the effectiveness of alternative therapies (such as controlling for the placebo effect).
Although additional studies are imperative, Lin and coauthors conclude, “The consensus and results of this review suggest that complementary health approaches can help to improve pain and reduce opioid use.”
Source: Wolters Kluwer Health/EurekAlert