Objectives: The purpose is to examine what is known about the efficacy of selected complementary and alternative medicine (CAM) therapies for pain from arthritis and related conditions based on systematic reviews and meta-analyses.
Methods: Results specifically related to pain were retrieved from review articles of acupuncture, homeopathy, herbal remedies, and selected nutritional supplements.
Results: Evidence exists to support the efficacy of reducing pain from osteoarthritis (OA) for acupuncture; devil's claw, avocado/soybean unsaponifiables, Phytodolor and capsaicin; and chondroitin, glucosamine, and SAMe. Strong support exists for gamma linolenic acid (GLA) for pain of rheumatoid arthritis (RA).
Conclusions: Despite support for some of the most popular CAM therapies for pain from arthritis-related conditions, additional high quality research is needed for other therapies, especially for herbals and homeopathy.
An estimated 30% to 70% of patients in developed countries use Complementary and Alternative Medicine (CAM), that is, practices that are not presently considered an integral part of conventional or mainstream medicine. It was estimated that 60 million adults in the US used CAM in 1990 with that number growing to 83 million by 1997, an increase of almost 40%. 1 Usage seems to be primarily for back pain, allergies, fatigue, arthritis, and headaches. In fact, those who use CAM regularly are more likely to be those experiencing severe pain. For example, in a 1997 survey of patients with rheumatic diseases, more than 60% indicated they had used some type of alternative care. 2 CAM includes a wide variety of therapies that can be categorized into 5 major domains: alternative medical systems such as acupuncture and homeopathic medicine, mind-body interventions, biologically based therapies that include herbal remedies, manipulative and body-based methods, and energy therapies.
As a general rule, CAM therapies have been under-researched as compared with conventional therapies. However, a growing body of empirical evidence has led to systematic reviews and meta-analyses for some of the therapies and some of the conditions. At present there are over 200 review articles in CAM, including systematic reviews and meta-analyses, with approximately 80 for arthritis and related diseases (available at http://www.campain.umm.edu/ris/risweb.isa). The purpose of this paper is to summarize what is known about the efficacy of selected CAM therapies for pain from arthritis and related diseases based on these reviews. The focus will be on acupuncture, homeopathy, herbal remedies, and selected nutritional supplements.