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Specific forms of complementary and alternative medicine (CAM) may help decrease the pain associated with osteoarthritis and fibromyalgia, according to a new report in Current Opinion in Rheumatology.1 Although many of these therapies have a long history of use in traditional medicine, it has only been recently that their effectiveness has been documented by scientific studies.
Several small trials examined the effects of acupuncture on joint degeneration (osteoarthritis) of the knee. The results of one study showed that acupuncture reduced pain by as much as 52%, compared with those receiving a sham treatment (acupuncture needles put in areas not associated with known acupuncture points). Acupuncture was found in another study to be as effective as transcutaneous electrical nerve stimulation (TENS), a well-accepted treatment for pain. A review article concludes that acupuncture is an effective adjunctive therapy for osteoarthritis and fibromyalgia.
Herbal medicines may be beneficial in the treatment of osteoarthritis of the hip, knee, and thumbs. One controlled study found that 435 mg per day of Devil’s claw (Harpagophytum procumbens) reduced pain in people with osteoarthritis of the knee or hip, and also decreased the need for additional conventional medications, compared with treatment consisting of only conventional medications. Another trial showed that ginger (Zingiber officinale) reduced knee and hip pain better than placebo, but was not as effective as ibuprofen.
Thumb and index finger pain was significantly reduced with a topical application of stinging nettle (Urtica dioica), while no benefit was found in the placebo group. Daily intake of willow bark (Salix purpurea) standardized to contain 240 mg of salicin was better than placebo in treating osteoarthritis of the hip or knee. An Ayurvedic (traditional Indian medicine) formula containing ashwagandha (Withania somnifera), frankincense (Boswellia serrata), ginger, and turmeric (Curcuma longa) significantly reduced joint swelling in people with rheumatoid arthritis, compared with placebo. However, pain was only mildly reduced.
Homeopathy has been investigated as a potential treatment for osteoarthritis, but only a few of the studies reviewed were deemed high quality. Although these studies favor the use of homeopathic treatment for knee and hip pain, they lack conclusive evidence. More research is necessary to determine the effectiveness of this treatment. Controlled studies have also examined magnet therapy and spiritual healing, but have failed to show any benefit from either.
People suffering from chronic joint and muscle pain may find relief with massage. One small study demonstrated that five weeks of classical massage therapy consisting of ten 20-minute sessions helped reduce pain and elevate mood, compared with conventional medications.
Some nutritional supplements may be useful for treating osteoarthritis. Multiple small trials have suggested that chondroitin sulfate, a substance that helps with the formation of cartilage, reduces joint pain. Some of these studies found a 50% reduction in pain, compared with placebo, but the authors point out that larger, longer-term studies are necessary to prove its usefulness. The more popular glucosamine sulfate also appears to be helpful in treating osteoarthritis. Although many of the studies were small, all but one showed some benefit. Some physicians recommend taking 1,500 mg per day of glucosamine sulfate; it may take up to three months of continuous use to notice the benefits.
Enzymes with anti-inflammatory effects (proteolytic enzymes), such as bromelain and trypsin, have been shown to be effective pain-reducing therapy for osteoarthritis. One study showed that taking two tablets three times daily of proteolytic enzymes was as effective as conventional medication in reducing knee pain. However, it is unknown what concentration of enzymes was used.
Another preliminary study looked at the use of melatonin for treating fibromyalgia. People given 3 mg per day of oral melatonin for thirty days reported less muscle tenderness and better quality of sleep. However, more studies are needed to confirm the effectiveness of melatonin in fibromyalgia.
1. Ernst E. Complementary and alternative medicine for pain management in rheumatic disease. Curr Opin Rheumatol 2002;14:58–62.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of Garlic and Cholesterol: Everything You Need to Know (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice in Westport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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