Top

Published in:

01-01-2021 | Acupuncture | Review

A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care

Authors: Ivan Urits, Ruben H. Schwartz, Vwaire Orhurhu, Nishita V. Maganty, Brian T. Reilly, Parth M. Patel, Christopher Wie, Alan D. Kaye, Ken F. Mancuso, Aaron J. Kaye, Omar Viswanath

Published in: Advances in Therapy | Issue 1/2021

Abstract

Introduction

Non-pharmacologic alternative therapies for pain have been around for a long time, some for hundreds of years. They have been used throughout history to treat many issues.

Recent Findings

Currently, alternative medicine is most frequently used to treat musculoskeletal pain, and between 59 and 90% of patients utilizing alternative therapies for chronic pain claimed they were helpful and can serve as an effective adjunctive for the treatment of chronic pain. Some examples of alternative therapies that will be discussed in this review include acupuncture, tai chi, osteopathic manipulation, and chiropractic care. Acupuncture, traditionally a Chinese practice, is becoming more popular across the world to attempt to relieve pain. It involves the placement of thin needles at various points in the body. The efficacy of acupuncture for pain is heavily debated. More research and discussion are necessary to determine the exact role it plays in the treatment of chronic pain. Tai chi is also a traditional Chinese practice that is often used as a form of meditation and for potential health benefits. Tai chi involves a series of complex movements such as squatting combined with deep breathing to achieve relaxation and pain reduction. Osteopathic manipulative treatment (OMT) is a technique used by both osteopathic physicians (DO) as well as other health professionals to manage a wide range of conditions in any given patient. The technique involves utilization and manipulation of the musculoskeletal system to achieve potential health benefits. OMT has been used as therapy for many issues but is commonly used for pain conditions.

Summary

Alternative therapies may serve as an effective adjunctive treatment modality for the management of chronic pain conditions. There has been a tremendous amount of research dictating the effectiveness of alternative therapies for chronic pain management. The purpose of this review is to provide a comprehensive evidence-based update of alternative therapy used for the management of chronic pain conditions.

Bauer BA, Tilburt JC, Sood A, Li G, Wang S. Complementary and alternative medicine therapies for chronic pain. Chin J Integr Med. 2016;22(6):403–11.PubMedCrossRef

Stoicea N, Costa A, Periel L, Uribe A, Weaver T, Bergese SD. Current perspectives on the opioid crisis in the US healthcare system. Medicine. 2019;98(20):e15425.PubMedPubMedCentralCrossRef

Stanos S, Brodsky M, Argoff C, Clauw DJ, D’Arcy Y, Donevan S, Gebke KB, Jensen MP, Lewis Clark E, McCarberg B, Park PW, Turk DC, Watt S. Rethinking chronic pain in a primary care setting. Postgrad Med. 2016;128(5):502–15.PubMedCrossRef

Fuentes AV, Pineda MD, Venkata KCN. Comprehension of top 200 prescribed drugs in the US as a resource for pharmacy teaching, training and practice. Pharmacy (Basel). 2018;6(2):43.PubMedCentralCrossRef

Skolnick P. The opioid epidemic: crisis and solutions. Annu Rev Pharmacol Toxicol. 2018;58:143–59.PubMedCrossRef

Alam A, Juurlink DN. The prescription opioid epidemic: an overview for anesthesiologists. Can J Anesth. 2016;63(1):61–8.CrossRefPubMed

Brown RE, Sloan PA. The opioid crisis in the United States. Anesth Analg. 2017;125(5):1432–4.PubMedCrossRef

Gostin LO, Hodge JG, Noe SA. Reframing the opioid epidemic as a national emergency. JAMA. 2017;318(16):1539.PubMedCrossRef

Labianca R, Sarzi-Puttini P, Zuccaro SM, Cherubino P, Vellucci R, Fornasari D. Adverse effects associated with non-opioid and opioid treatment in patients with chronic pain. Clin Drug Investig. 2012;32(Suppl 1):53–63.PubMedCrossRef

10.

Kroenke K, Cheville A. Management of chronic pain in the aftermath of the opioid backlash. JAMA. 2017;317(23):2365.PubMedCrossRef

11.

Simpson CA. Complementary medicine in chronic pain treatment. Phys Med Rehabil Clin N Am. 2015;26(2):321–47. https://doi.org/10.1016/j.pmr.2014.12.005.CrossRefPubMed

12.

Vickers AJ, Cronin AM, Maschino AC, Lewith G, Macpherson H, Victor N, Foster NE, Sherman KJ, Witt CM. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444–53. https://doi.org/10.1001/archinternmed.2012.3654.CrossRefPubMedPubMedCentral

13.

Patil S, Sen S, Bral M, Reddy S, Bradley KK, Cornett EM, Fox CJ, Kaye AD. The role of acupuncture in pain management. Curr Pain Headache Rep. 2016;20(4):22.PubMedCrossRef

14.

Hall A, Copsey B, Richmond H, Thompson J, Ferreira M, Latimer J, Maher CG. Effectiveness of tai chi for chronic musculoskeletal pain conditions: updated systematic review and meta-analysis. Phys Ther. 2017;97(2):227–38.PubMedCrossRef

15.

Lj G. Cochrane database of systematic reviews physical activity and exercise for chronic pain in adults: an overview of cochrane reviews (review) physical activity and exercise for chronic pain in adults: an overview of cochrane reviews (review). Cochrane Database Syst Rev. 2017;1(1):CD011279. https://doi.org/10.1002/14651858.CD011279.pub2.CrossRef

16.

Franke H, Franke J-D, Belz S, Fryer G. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: a systematic review and meta-analysis. J Bodyw Mov Ther. 2017;21(4):752–62.PubMedCrossRef

17.

Garland EL. Treating chronic pain: the need for non-opioid options. Expert Rev Clin Pharmacol. 2014;7(5):545–50.PubMedCrossRef

18.

Lao L. Acupuncture techniques and devices. J Altern Complement Med. 1996;2(1):23–5.PubMedCrossRef

19.

Wilkinson J, Faleiro R. Acupuncture in pain management. Contin Educ Anaesth Crit Care Pain. 2007;7(4):135–8.CrossRef

20.

Lim T-K, Ma Y, Berger F, Litscher G. Acupuncture and neural mechanism in the management of low back pain-an update. Medicines. 2018;5(3):63.PubMedCentralCrossRef

21.

Thomas KJ, MacPherson H, Thorpe L, Brazier J, Fitter M, Campbell MJ, Roman M, Walters SJ, Nicholl J. Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. BMJ. 2006;333(7569):623.PubMedPubMedCentralCrossRef

22.

Cho Y-J, Song Y-K, Cha Y-Y, Shin B-C, Shin I-H, Park H-J, Lee H-S, Kim K-W, Cho J-H, Chung W-S, Lee J-H, Song M-Y. Acupuncture for chronic low back pain: a multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. Spine. 2013;38(7):549–57.PubMedCrossRef

23.

Pach D, Yang-Strobel X, Lüdtke R, Roll S, Icke K, Brinkhaus B, Witt CM. Standardized versus individualized acupuncture for chronic low back pain: a randomized controlled trial. Evid Based Complement Altern Med. 2013;2013:125937.CrossRef

24.

Zhang X, Wang Y, Wang Z, Wang C, Ding W, Liu Z. A randomized clinical trial comparing the effectiveness of electroacupuncture versus medium-frequency electrotherapy for discogenic sciatica. Evid Based Complement Altern Med. 2017;2017:9502718.

25.

Shin J-Y, Ku B, Kim JU, Lee YJ, Kang JH, Heo H, Choi H-J, Lee J-H. Short-term effect of laser acupuncture on lower back pain: a randomized, placebo-controlled, double-blind trial. Evid Based Complement Altern Med. 2015;2015:808425.

26.

Foster NE, Bishop A, Bartlam B, Ogollah R, Barlas P, Holden M, Ismail K, Jowett S, Kettle C, Kigozi J, Lewis M, Lloyd A, Waterfield J, Young J. Evaluating acupuncture and standard care for pregnant women with back pain (EASE Back): a feasibility study and pilot randomised trial. Health Technol Assess. 2016;20(33):1–236.PubMedPubMedCentralCrossRef

27.

Bhardwaj A, Nagandla K. Musculoskeletal symptoms and orthopaedic complications in pregnancy: pathophysiology, diagnostic approaches and modern management. Postgrad Med J. 2014;90(1066):450–60.PubMedCrossRef

28.

Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;2015(9):CD001139. https://doi.org/10.1002/14651858.CD001139.pub4.CrossRefPubMedCentral

29.

Smith CA, Collins CT, Crowther CA, Levett KM. Acupuncture or acupressure for pain management in labour. Cochrane Database Syst Rev. 2011;(7):CD009232. https://doi.org/10.1002/14651858.CD009232.

30.

Schlaeger JM, Gabzdyl EM, Bussell JL, Takakura N, Yajima H, Takayama M, Wilkie DJ. Acupuncture and Acupressure in Labor. J Midwifery Womens Health. 2017;62(1):12–28.PubMedCrossRef

31.

Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, Vickers A, White AR. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;6:CD001218.

32.

Allais G, Sinigaglia S, Airola G, Rolando S, De Lorenzo C, Chiarle G, Benedetto C. Ear acupuncture in the prophylactic treatment of chronic migraine. Neurol Sci. 2019;40(Suppl 1):211–2. https://doi.org/10.1007/s10072-019-03800-y.CrossRefPubMed

33.

Nie L, Cheng J, Wen Y, Li J. The effectiveness of acupuncture combined with tuina therapy in patients with migraine. Complement Med Res. 2019;26(3):182–94. https://doi.org/10.1159/000496032.CrossRefPubMed

34.

Pei P, Liu L, Zhao L-P, Qu Z-Y, Tang C-Y, Wang L-P, Yang W. Electroacupuncture exerts an anti-migraine effect via modulation of the 5-HT7 receptor in the conscious rat. Acupunct Med. 2019;37(1):47–54. https://doi.org/10.1136/acupmed-2017-011410.CrossRefPubMed

35.

Gu T, Lin L, Jiang Y, Chen J, D’Arcy RC, Chen M, Song X. Acupuncture therapy in treating migraine: results of a magnetic resonance spectroscopy imaging study. J Pain Res. 2018;11:889–900.PubMedPubMedCentralCrossRef

36.

Kim J-M, Jeon H-J, Kim H-J, Cho C-K, Yoo H-S. Bee venom pharmacopuncture: an effective treatment for complex regional pain syndrome. J pharmacopuncture. 2014;17(4):66–9.PubMedPubMedCentralCrossRef

37.

Mazzardo-Martins L, Salm DC, Winkelmann-Duarte EC, Ferreira JK, Lüdtke DD, Frech KP, Belmonte LAO, Horewicz VV, Piovezan AP, Cidral-Filho FJ, Moré AOO, Martins DF. Electroacupuncture induces antihyperalgesic effect through endothelin-B receptor in the chronic phase of a mouse model of complex regional pain syndrome type I. Pflüg Arch Eur J Physiol. 2018;470(12):1815–27.CrossRef

38.

Wang C, Li K, Choudhury A, Gaylord S. Trends in yoga, tai chi, and qigong use among US adults, 2002–2017. Am J Public Health. 2019;109(5):755–61.PubMedCrossRef

39.

Weifen W, Muheremu A, Chaohui C, Wenge L, Lei S. Effectiveness of tai chi practice for non-specific chronic low back pain on retired athletes: a randomized controlled study. J Musculoskelet Pain. 2013;21(1):37–45.CrossRef

40.

Hall AM, Maher CG, Lam P, Ferreira M, Latimer J. Tai chi exercise for treatment of pain and disability in people with persistent low back pain: a randomized controlled trial. Arthritis Care Res. 2011;63(11):1576–83.CrossRef

41.

Zou L, Zhang Y, Liu Y, Tian X, Xiao T, Liu X, Yeung AS, Liu J, Wang X, Yang Q. The effects of tai chi chuan versus core stability training on lower-limb neuromuscular function in aging individuals with non-specific chronic lower back pain. Medicina. 2019;55(3):60.PubMedCentralCrossRef

42.

Liu J, Yeung A, Xiao T, Tian X, Kong Z, Zou L, Wang X. Chen-style tai chi for individuals (aged 50 years old or above) with chronic non-specific low back pain: a randomized controlled trial. Int J Environ Res Public Health. 2019;16(3):517.PubMedCentralCrossRef

43.

Moore AA, Lake JE, Glasner S, Karlamangla A, Kuerbis A, Preciado D, Jenkins J, Dominguez BX, Candelario J, Liao DH, Tang L, Reid MC. Establishing the feasibility, acceptability and preliminary efficacy of a multi-component behavioral intervention to reduce pain and substance use and improve physical performance in older persons living with HIV. J Subst Abuse Treat. 2019;100:29–38.PubMedPubMedCentralCrossRef

44.

Burschka JM, Keune PM, Oy UH, Oschmann P, Kuhn P. Mindfulness-based interventions in multiple sclerosis: beneficial effects of tai chi on balance, coordination, fatigue and depression. BMC Neurol. 2014;14:165.PubMedPubMedCentralCrossRef

45.

Taylor E, Taylor-Piliae RE. The effects of tai chi on physical and psychosocial function among persons with multiple sclerosis: a systematic review. Complement Ther Med. 2017;31:100–8.PubMedCrossRef

46.

Tavee J, Rensel M, Planchon SM, Butler RS, Stone L. Effects of meditation on pain and quality of life in multiple sclerosis and peripheral neuropathy: a pilot study. Int J MS Care. 2011;13(4):163–8.PubMedPubMedCentralCrossRef

47.

Tsai P-F, Kitch S, Chang JY, James GA, Dubbert P, Roca JV, Powers CH. Tai chi for posttraumatic stress disorder and chronic musculoskeletal pain: a pilot study. J Holist Nurs. 2018;36(2):147–58.PubMedCrossRef

48.

Grodin MA, Piwowarczyk L, Fulker D, Bazazi AR, Saper RB. Treating survivors of torture and refugee trauma: a preliminary case series using qigong and t’ai chi. J Altern Complement Med. 2008;14(7):801–6.PubMedPubMedCentralCrossRef

49.

Slattengren AH, Nissly T, Blustin J, Bader A, Westfall E. Best uses of osteopathic manipulation. J Fam Pract. 2017;66(12):743–7.PubMed

50.

Clinical Guideline Subcommittee on Low Back Pain, American Osteopathic Association. American Osteopathic Association guidelines for osteopathic manipulative treatment (OMT) for patients with low back pain. J Am Osteopath Assoc. 2010;110(11):653–66.

51.

Licciardone JC, Gatchel RJ, Aryal S. Recovery from chronic low back pain after osteopathic manipulative treatment: a randomized controlled trial. J Am Osteopath Assoc. 2016;116(3):144–55.PubMedCrossRef

52.

Cerritelli F, Ginevri L, Messi G, Caprari E, Di Vincenzo M, Renzetti C, Cozzolino V, Barlafante G, Foschi N, Provinciali L. Clinical effectiveness of osteopathic treatment in chronic migraine: 3-armed randomized controlled trial. Complement Ther Med. 2015;23(2):149–56.PubMedCrossRef

53.

Goertz CM, Salsbury SA, Long CR, Vining RD, Andresen AA, Hondras MA, Lyons KJ, Killinger LZ, Wolinsky FD, Wallace RB. Patient-centered professional practice models for managing low back pain in older adults: a pilot randomized controlled trial. BMC Geriatr. 2017;17(1):235.PubMedPubMedCentralCrossRef

54.

Moore C, Adams J, Leaver A, Lauche R, Sibbritt D. The treatment of migraine patients within chiropractic: analysis of a nationally representative survey of 1869 chiropractors. BMC Complement Altern Med. 2017;17(1):1–10.CrossRef

55.

Chaibi A, Benth J, Tuchin PJ, Russell MB. Chiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial. Eur J Neurol. 2017;24(1):143–53.PubMedCrossRef

56.

Bussières AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Hayden J, Hendrickson B, Hincapié C, Pagé I, Passmore S, Srbely J, Stupar M, Weisberg J, Ornelas J. The treatment of neck pain-associated disorders and whiplash-associated disorders: a clinical practice guideline. J Manip Physiol Ther. 2016;39(8):523-564.e27.CrossRef

Title: A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care
Authors: Ivan Urits
Ruben H. Schwartz
Vwaire Orhurhu
Nishita V. Maganty
Brian T. Reilly
Parth M. Patel
Christopher Wie
Alan D. Kaye
Ken F. Mancuso
Aaron J. Kaye
Omar Viswanath
Publication date: 01-01-2021
Publisher: Springer Healthcare
Keywords: Acupuncture
Migraine
Complex Regional Pain Syndrome
Opioids
Opioids
Care
Complex Regional Pain Syndrome
Back Pain
Back Pain
Back Pain
Published in: Advances in Therapy / Issue 1/2021
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI: https://doi.org/10.1007/s12325-020-01554-0

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 1/2021

Real-World Evidence to Contextualize Clinical Trial Results and Inform Regulatory Decisions: Tofacitinib Modified-Release Once-Daily vs Immediate-Release Twice-Daily for Rheumatoid Arthritis

Real-World Bleeding and Ischemic Events in Asian Patients on P2Y12-Inhibitors After Percutaneous Coronary Intervention: A National Claims Data Analysis

Antimicrobial Stewardship in the Intensive Care Unit: The Role of Biomarkers, Pharmacokinetics, and Pharmacodynamics

Radiation-Induced Sarcomas of the Head and Neck: A Systematic Review

Treatment Pattern and Outcomes in Newly Diagnosed Multiple Myeloma Patients Who Did Not Receive Autologous Stem Cell Transplantation: A Real-World Observational Study

Comparative Analysis of the Temporomandibular Joints in Patients with Chronic Periodontitis Using Cone-Beam Computed Tomography (CBCT)

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage