• The authors of this review evaluated the available evidence regarding the use of complementary health approaches to assist in the management of chronic pain. There was positive evidence to show that some strategies may be beneficial for specific complaints.
• Select complementary health approaches may be beneficial for patients with chronic pain in situations where medication is ineffective or causes unwanted side effects.

Evidence-based complementary therapies for pain

With the growing epidemic of opioid abuse and dependence, it is important to explore non-pharmaceutical strategies to help relieve pain and suffering. This systematic review evaluated different pain scenarios treated with specific complementary therapies.

The authors included randomized controlled trials conducted in the United States. This strategy recognized the cross-cultural differences in complementary therapies. For example, in many countries, these therapies don’t have the “complementary” label and are already integrated into routine care.

In summary, the authors concluded that there is good evidence to support the use of acupuncture and yoga for back pain; acupuncture and tai chi for osteoarthritis of the knee; massage therapy for neck pain; and relaxation techniques for headaches.

In my experience in reviewing this literature, if we touch someone, stick him or her with something sharp, or reduce the person’s perceived stress, pain generally improves. But if we rely only on passive treatments wherein something is done to a person with no self-reflection involved, the improvement rarely sticks.

When I started my integrative medicine fellowship, I was under a lot of stress, in part because I packed up my wife and three kids and went back to school after being in private practice, which resulted in some financial insecurity. I was holding a lot of stress in my neck, which was causing pain and headaches. I was lucky enough to be treated by one of our DO faculty who used strain–counter strain (positional release therapy) and sub-occipital release. But he did more than just provide this passive treatment. He inquired about the stress of moving my family and leaving home. His passive treatment became active because he integrated the therapy into the context of my life. And the benefits I received from his magical hands and kind words persisted.

Evidence-based reviews are important but will always be somewhat anemic because they control for those nonspecific variables that define the art of our work.

For a simple manual intervention for neck pain and headaches, check out this video on how to do a sub-occipital release. And when you are gently elongating the fascia of the sub-occipital spine, consider gently inquiring about why that person may be holding stress in his/her neck.

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