CAM in Chronic Pain and Palliative Care
Complementary and alternative medicine (CAM) encompasses diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Conventional medicine (also called Western or allopathic medicine) is medicine as practiced by holders of M.D. (medical doctor) and D.O. (doctor of osteopathy) degrees and by allied health professionals, such as physical therapists, psychologists, and registered nurses. The boundaries between CAM and conventional medicine are not absolute, and specific CAM practices may, over time, become widely accepted. Despite the fact that rigorous, well-designed clinical trials for many CAM therapies are often lacking and, therefore, the safety and effectiveness of many CAM therapies are uncertain, CAM use is common, particularly among individuals with chronic pain and advanced illness. This chapter presents evidence regarding selected CAM modalities in the settings of chronic pain and palliative care. The presentation of the evidence is organized according to the following NCCAM-specified categories: (1) mind–body practices, (2) manipulative and body-based practices, (3) manipulation of energy fields, and (4) biologically based therapies. Where sufficient data are available, the evidence is presented in table format. For some modalities, little evidence is available. For these modalities, the existing evidence is described in the text only. Despite many years of CAM practice and common usage, rigorous scientific research on CAM therapies has occurred only relatively recently. CAM research is limited by methodologic and ethical issues. Gaps in research are thus the norm and the current evidence base is insufficient.
KeywordsPlacebo Fatigue Arthritis Depression Osteoporosis
- Achterberg, J. (1998b). Clearing the air in the therapeutic touch controversy. Alternative Therapies, 4(4), 100–101.Google Scholar
- Barnes, P., Bloom, B., & Nahin, R. (2007). Complementary and alternative medicine use among adults and children: United States. National Center for Health Station and National Center for Complementary and Alternative Medicine, National Institute of Health (reprint).Google Scholar
- Bausewein, C., Booth, S., Gysels, M., & Higginson, I. (2008). Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database of Systemic Reviews. (2), CD005623.Google Scholar
- Bronfort, G., Goldsmith, C. H., Nelson, C. F., Boline, P. D., & Anderson, A. V. (1996). Trunk exercise combined with spinal manipulative or NSAID therapy for chronic low back pain: A randomized, observer-blinded clinical trial. Journal of Manipulative and Physiological Therapeutics, 19(9), 570–582.PubMedGoogle Scholar
- Castronova, J., & Oleson, T. (1991). A comparison of supportive psychotherapy and laying-on of hands healing for chronic back pain patients. Alternative Medicine, 3(4), 217–226.Google Scholar
- Colbert, A. P., Banerji, M., & Pilla, A. A. (1999). Magnetic matress pad use in patients with fibromyalgia: A randomised double-blind pilot study. Journal of Back and Musculoskeletal Rehabilitation, 13, 19–31.Google Scholar
- Corbin, L. W., Mellis, K. B., Beaty, B.L., & Kutner, J. S. (2010). The use of complementary and Alternative Medicine Theraphies by Patients with Advanced Cancer in a hospice setting: A Multicentered Description Study. I Palliative Medicine, 12(1), 7–8.Google Scholar
- Corner, J., Cawley, N., & Hildebrand, S. (1995). An evaluation of the use of massage and essential oils on the wellbeing of cancer patients. International Journal of Palliative Nursing, 1(2), 67–73.Google Scholar
- Dressen, L. J., & Singg, S. (1998). Effects of Reiki on pain and selected affective and personality variables of chronically ill patients. Subtle Energies & Energy Medicine, 9(1), 51–82.Google Scholar
- Fellowes, D., Barnes, K., & Wilkinson, S. (2004). Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database of Systemic Reviews. (2), CD002287.Google Scholar
- Furlan, A. D., Imamura, M., Dryden, T., & Irvin, E. (2008). Massage for low-back pain. Cochrane Database of Systemic Reviews. (4), CD001929.Google Scholar
- Gehlart, C., Forbes, M. A., & Schmid, M. M. (2000). The effect of healing touch on pain and mood in institutionalized elders. Healing Touch Newsletter, 10(3), 8.Google Scholar
- Giles, L. G., Muller, R., Giles, L. G., & Muller, R. (2003). Chronic spinal pain: A randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine (Phila Pa 1976)., 28(14), 1490–1502. discussion 1502–1493.Google Scholar
- Hurwitz, E. L., Morgenstern, H., Harber, P., Kominski, G. F., Yu, F., & Adams, A. H. (2002). A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: Clinical outcomes from the UCLA neck-pain study. American Journal of Public Health, 92(10), 1634–1641.PubMedCrossRefGoogle Scholar
- Koopsen, C., & Young, C. (2009). Integrative health: A holistic approach for health professionals. Boston: Jones & Bartlett.Google Scholar
- Leskowitz, E. (1998). Un-debunking therapeutic touch. Alternative Therapies, 4(4), 101–102.Google Scholar
- Myers, C. D., Robinson, M. E., Guthrie, T. H., et al. (1999). Adjunctive approaches for sickle cell chronic pain. Alternaticw Health Practioners, 5(3), 203–212.Google Scholar
- National Guidelines Clearinghouse. (2010). Chronic pain. Retrieved 7 October, 2010, from http://www.guidelines.gov/popups/printview.aspx?id=14284.
- National Health Interview Survey. Retrieved 2010, from http://www.cdc.gov/nchs/nhis.htm.
- Natural Standard. (2010). Monograph on massage therapy. Reteieved 8 January, 2010, from http://www.naturalstandard.com.
- Natural Standard. (2010). Chiropractic. Retrieved 2010, from http://www.naturalstandard.com.
- Nelson, C. F., Bronfort, G., Evans, R., Boline, P., Goldsmith, C., & Anderson, A. V. (1998). The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Journal of Manipulative and Physiological Therapeutics, 21(8), 511–519.PubMedGoogle Scholar
- Pan, C. X., Morrison, R. S., Ness, J., Fugh-Berman, A., & Leipzig, R. M. (2000). Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life. A systematic review. Journal of Pain and Symptom Management, 20(5), 374–387.PubMedCrossRefGoogle Scholar
- Philcox, P., Rawlins, L., & Rodgers, L. (2002). Therapeutic touch and its effects on phantom limb and stump pain. Journal of the Australian Rehabilitation Nursing Association, 5(1), 17–21.Google Scholar
- Proctor, M. L., Hing, W., Johnson, T. C., & Murphy, P. A. (2006). Spinal manipulation for primary and secondary dysmenorrhoea. Cochrane Database of Systemic Reviews. (3), CD002119.Google Scholar
- Puustjarvi, K., Airaksinen, O., & Pontinen, P. J. (1990). The effects of massage in patients with chronic tension headache. Acupuncture & Electro-Therapeutics Research, 15(2), 159–162.Google Scholar
- Rausch, S. M., Winegardner, F., Kruk, K. M., et al. (2011) Complementary and alternative medicine: Use and disclosure in radiation oncology community practice. Support Care Cancer, 19(4), 521–529.Google Scholar
- Redner, R., Briner, B., & Snellman, L. (1991). Effects of bioenergy healing technique on chronic pain. Subtle Energies, 2(3), 43–68.Google Scholar
- Retrieved 10 October, 2010, from http://www.reflexology-usa.org/articles/definitions_of_reflexology.html.
- Retrieved October 3, 2010, from http://nccam.nih.gov/health/whatiscam/.
- Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010). Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research., 68(1), 29–36.PubMedCrossRefGoogle Scholar
- Royal College of General Practitioners. (2009). Low back pain; early management of persistent non-specific low back pain. Clinical guideline no. 88. London: Royal College of General Practitioners.Google Scholar
- Sapir, R. B., Sherman, K. J., Cullum-Dugan, D., Davis, R. B., Phillips, R. S., & Culpepper, L. (2009). Yoga for chronic low back pain in a predominantly minority population: A pilot randomized controlled trial. Alternative Therapies in Health and Medicine, 15(6), 18–27.Google Scholar
- Schechter, D., Smith, A. P., Beck, J., Roach, J., Karim, R., & Azen, S. (2007). Outcomes of a mind-body treatment program for chronic back pain with no distinct structural pathology–a case series of patients diagnosed and treated as tension myositis syndrome. Alternative Therapies in Health and Medicine, 13(5), 26–35.PubMedGoogle Scholar
- Slater, V. (1996). Safety, elements and effects of healing touch on chronic non-malignant abdominal pain. Knoxville: University of Tennessee.Google Scholar
- Smith, M. C. (2005). Complementary-alternative therapies: From pseudo to serious science. Communicating Nursing Research, 38, 23–38.Google Scholar
- So, P. S., Jiang, Y., & Qin, Y. (2008). Touch therapies for pain relief in adults. Cochrane Database of Systemic Reviews. (4), CD006535.Google Scholar
- Tekur, P., Singphow, C., Nagendra, H. R., & Raghuram, N. (2008). Effect of short-term intensive yoga program on pain, functional disability and spinal flexibility in chronic low back pain: A randomized control study. Journal of Alternative and Complementary Medicine, 14(6), 637–644.CrossRefGoogle Scholar
- van Tulder, M., Furlan, A., Bombardier, C., & Bouter, L. (2003). Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine (Phila Pa 1976), 28(12), 1290–1299.Google Scholar
- Walker, B. F., French, S. D., Grant, W., & Green, S. (2010). Combined chiropractic interventions for low-back pain. Cochrane Database of Systemic Reviews. (4), CD005427.Google Scholar
- Weymouth, K., & Sandberg-Lewis, S. (2000). Comparing the efficacy of healing touch and chiropractic adjustment in treating chronic low back pain: A pilot study. Healing Touch Newsletter, 00(3), 7–8.Google Scholar
- White House Commission on Complementary and Alternative Medicine. (2010). Retrieved 2010, from http://www.whccamp.hhs.gov.
- Wilkie, D. J., Kampbell, J., Cutshall, S., et al. (2000). Effects of massage on pain intensity, analgesics and quality of life in patients with cancer pain: A pilot study of a randomized clinical trial conducted within hospice care delivery. The Hospice Journal, 15(3), 31–53.PubMedCrossRefGoogle Scholar
- Wilkinson, S. (1995). Aromatherapy and massage in palliative care. International Journal of Palliative Nursing, 1(1), 21–30.Google Scholar