The term ''alternative therapy'' generally is used to describe any medical treatment or intervention that is used in place of conventional medicine. When alternative therapies are used in conjunction with conventional medicine, it is called complementary medicine. Alternative therapy encompasses a variety of disciplines, including acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage and many others.
Acupuncture
Although the World Health Organization currently recognizes more than 30 diseases or conditions that can be helped by acupuncture treatment, one of the main uses of acupuncture is for pain relief.
Sixteenth Century Chinese doctors believed that illness was due to an imbalance of energy in the body. In acupuncture, disposable, stainless steel needles are used to stimulate the body's 14 major meridians, or energy-carrying channels, to resist or overcome illnesses and conditions by correcting these imbalances.
Acupuncture is also thought to decrease pain by increasing the release of chemicals that block pain, called endorphins. Many acu-points are near nerves. When stimulated, these nerves cause a dull ache or feeling of fullness in the muscle. The stimulated muscle sends a message to the central nervous system (the brain and spinal cord), causing the release of endorphins (morphine-like chemicals produced in our own bodies during times of pain or stress). Endorphins, along with other neurotransmitters (body chemicals that modify nerve impulses), block the message of pain from being delivered up to the brain.
Acupuncture may be useful as an accompanying treatment for many pain-related conditions, including: headache, low back pain, menstrual cramps, carpal tunnel syndrome, tennis elbow, fibromyalgia, osteoarthritis and myofascial pain. Acupuncture also may be an acceptable alternative to or may be included as part of a comprehensive pain management program.
Chiropractic Treatment and Massage
Chiropractic treatment is the most common non-surgical treatment for back pain. Improvements in people undergoing chiropractic manipulations were noted in some trials. However, the treatment's effectiveness in treating back and neck pain has not been supported by compelling evidence from the majority of clinical trials. Further studies are currently assessing the effectiveness of chiropractic care for pain management.
Massage is being increasingly used by people suffering from pain, mostly to manage chronic back and neck problems. Massage can reduce stress and relieve tension by enhancing blood flow. This treatment also can reduce the presence of substances that may generate and sustain pain. Available data suggest that massage therapy, like chiropractic manipulations, holds considerable promise for managing back pain.
Capsaicin: For arthritis, shingles, or neuropathy
What the science says: An active component of chile pepper, capsaicin temporarily desensitizes pain-prone skin nerve receptors called C-fibers; soreness is diminished for 3 to 5 weeks while they regain sensation. Nearly 40 percent of arthritis patients reduced their pain by half after using a topical capsaicin cream for a month, and 60 percent of neuropathy patients achieved the same after 2 months, according to a University of Oxford study. Patients at the New England Center for Headache decreased their migraine and cluster headache intensity after applying capsaicin cream inside their nostrils.
How to try it: Capsaicin ointments and creams are sold in pharmacies and health stores. For arthritis or neuropathy, try 0.025 percent or 0.075 percent capsaicin cream one to four times daily; best results can take up to 2 weeks, says Philip Gregory, PharmD, a professor at Creighton University and editor of the Natural Medicines Comprehensive Database. But research on capsaicin and headaches remains limited — and don't expect stronger versions anytime soon: "Current formulations are better suited for more acute problems, like a sore muscle or an arthritis flare-up, than everyday pain and stiffness," Gregory says.
InflaThera or Zyflamend: For arthritis
What the science says: Both supplement brands contain ginger, turmeric, and holy basil, all of which have anti-inflammatory properties. Turmeric (a curry ingredient) may be the best: A component, curcumin, eases inflammatory conditions like rheumatoid arthritis and psoriasis, according to the Methodist Research Institute in Indianapolis. Researchers are now testing Zyflamend in RA patients, but some experts are already sold: "Each herb has its own scientific database of evidence," says James Dillard, MD, author of "The Chronic Pain Solution."
How to try it: ProThera, InflaThera's maker, will only sell to health care professionals, so your doctor has to order it for you; that said, it's reportedly stronger (and slightly cheaper) than Zyflamend. InflaThera's suggested dosage is twice daily with food. For the more readily accessible Zyflamend, take one capsule two or three times daily, but avoid it near bedtime — each pill contains 10 mg of caffeine (another version, Zyflamend PM, is reportedly less stimulating). Buy Zyflamend at swansonvitamins.com or immunesupport.com/zyflamend.htm. Or, save money and try curcumin to start: Taking 500 mg four times daily, along with fish oil and a diet low in animal fat, can ease arthritis, says Jane Guiltinan, ND, immediate past president of the American Association of Naturopathic Physicians.
Aquamin: For osteoarthritis
What the science says: This red seaweed supplement is rich in calcium and magnesium. A preliminary clinical study showed that the ingredients may reduce joint inflammation or even help build bone, says David O'Leary of Marigot, Aquamin's Irish manufacturer. In a study of 70 volunteers published in Nutrition Journal, Aquamin users reduced arthritis pain by 20 percent in a month, and had less stiffness than patients taking a placebo.
How to try it: Marigot recommends 2,400 mg a day (two capsules) of Aquamin in tablet form, sold domestically in products such as Aquamin Sea Minerals and Cal-Sea-Um. A 60-pill jar of Swanson Vegetarian Aquamin Sea Minerals costs about $6 at swansonvitamins.com.
Fish oil: For joint pain from arthritis or autoimmune disorders
What the science says: Digested fish oil breaks down into hormonelike chemicals called prostaglandins, which reduce inflammation. In one study, about 40 percent of rheumatoid arthritis patients who took cod-liver oil every day were able to cut their NSAID use by more than a third, Scottish scientists recently reported. People with neck and back pain have fared even better: After about 10 weeks, nearly two-thirds were able to stop taking NSAIDs altogether in a University of Pittsburgh study.
How to try it: Taking 1,000 mg is proven to help your heart, but you should up the dose for pain. For osteoarthritis, try 2,000 to 4,000 mg daily; for rheumatoid arthritis and autoimmune diseases associated with joint pain (such as lupus), consider a much higher dose of upwards of 8,000 mg daily — but ask your doctor about such a large amount first, says Tanya Edwards, MD, medical director at the Cleveland Clinic's Center for Integrative Medicine. (The same rule applies if you take BP or heart meds, as omega-3s can thin the blood.) Read the nutrition label carefully: The dosage refers to the amount of omega-3s in a capsule, not other ingredients. Nordic Naturals (nordicnaturals.com) and Carlson (carlsonlabs.com) are both reputable brands; for something stronger, GNC's Triple-Strength Fish Oil (gnc.com) has 900 mg of omega-3s per capsule.
Methylsulfonyl-methane (MSM): For osteoarthritis
What the science says: MSM is derived from sulfur and may prevent joint and cartilage degeneration, say University of California, San Diego, scientists. People with osteoarthritis of the knee who took MSM had 25 percent less pain and 30 percent better physical function at the end of a 3-month trial at Southwest College of Naturopathic Medicine and Health Sciences. Indian researchers also found that MSM worked better when combined with glucosamine.
How to try it: Start with 1.5 to 3 g once daily and increase to 3 g twice daily for more severe pain, suggests Leslie Axelrod, ND, a professor of clinical sciences at Southwest. Patients in the Indian trial improved on dosages as low as 500 mg three times daily. Vendors of OptiMSM, the brand tested in Axelrod's trial, can be found at optimsm.com
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