Clinical Review State of the Art Review

Management of chronic pain using complementary and integrative medicine

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1284 (Published 24 April 2017) Cite this as: BMJ 2017;357:j1284
  1. Lucy Chen, medical doctor and associate professor1 2,
  2. Andreas Michalsen, medical doctor and professor of medicine3 4
  1. 1MGH Center for Translational Pain Research, Pain Management Center of MGH, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
  2. 2Harvard Medical School, Boston, MA 02115, USA
  3. 3Institute for Social Medicine, Epidemiology and Health Economics and Immanuel Hospital Berlin, Berlin, Germany
  4. 4Charité - Universitätsmedizin Berlin, Berlin, Germany
  1. Correspondence to: L Chen llchen{at}mgh.harvard.edu

Abstract

Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronic pain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronic pain, it remains inadequately controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use. CIM offers a multimodality treatment approach that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. This review focuses on the use of CIM in three conditions with a high incidence of chronic pain: back pain, neck pain, and rheumatoid arthritis. It summarizes research on the mechanisms of action and clinical studies on the efficacy of commonly used CIM modalities such as acupuncture, mind-body system, dietary interventions and fasting, and herbal medicine and nutrients.

Footnotes

  • Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors

  • Contributors: Both authors contributed equally to the manuscript.

  • Competing interests: We have read and understood the BMJ policy on declaration of interests and declare the following interests: none.

  • Provenance and peer review: Commissioned; externally peer reviewed.

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