Yoga and Acupuncture Effective for Chronic Pain Management

New research finds that complementary health approaches such as acupuncture, manipulation, massage therapy, tai chi, and yoga can be effective in managing chronic pain and related disability.

In an analysis of the MEDLINE database, a team led by Richard Nahin, PhD, MPH, of the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH), identified 150 randomized, controlled trials from the past 50 years that examined the effects of nondrug approaches to managing chronic pain.
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Nahin and colleagues examined the clinical trial evidence for the efficacy and safety of several specific approaches including acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements (chondroitin, glucosamine, methylsulfonylmethane, S-adenosylmethionine), tai chi, and yoga.

The authors evaluated the safety and efficacy of these approaches for the treatment of back pain, osteoarthritis, neck pain, fibromyalgia, and severe headaches and migraine, which are some of the most common pain conditions. Treatments were considered effective if they contributed to improvements in pain severity and pain-related disability and/or function that were statistically relevant in comparison with a control group.

The investigators found strong evidence to suggest that yoga and acupuncture are safe and effective for back pain. Acupuncture and tai chi might also benefit individuals with pain as a result of osteoarthritis of the knee, according to the authors, who added that results indicate massage therapy is safe and effective for short-term relief of neck pain, especially in 1-hour sessions done 2 to 3 times a week.

In addition, evidence suggested that relaxation techniques are safe and effective for treating severe headaches and migraine, while persons with back pain could also benefit from spinal manipulation, massage therapy, and osteopathic manipulation. Tai chi and relaxation approaches may do the same for fibromyalgia patients, although the authors note that this association was not as strong.

"One major goal for this study was to be as relevant as possible to primary care providers in the United States, who frequently see and care for patients with painful conditions," Dr Nahin said. "Providers need more high-quality information on the evidence base for pain management tools. These data give providers and patients additional information they need to have informed discussions about nondrug approaches for chronic pain."

—Mark McGraw

Reference

Nahin RL, Boineau R, Khalsa PS, Stussman BJ, Weber WJ. Evidence-based evaluation of complementary health approaches for pain management in the United States. Mayo Clin Proc. 2016;91(9):1292-1306.