Mixed efficacy found for CAM approaches to treating chronic pain

A review in the Journal of Rehabilitation Research and Development has found mixed efficacy for complementary and alternative medicine therapies for back and chronic pain.

From the abstract:

We review published research on commonly used complementary and alternative medicine (CAM) approaches to treating chronic pain. Our findings show that CAM therapies, as a group, have a mixed track record of efficacy. The modalities that have the best track records for pain management include biofeedback, hypnosis, and massage (mostly for low back pain and shoulder pain). In selecting a CAM modality, practitioners must weigh the pros and cons and tailor the interventions to the needs of patients with chronic pain. Other issues relevant to practitioners include additional time and energy investments, need for specialized training to administer the modality, side effects or potential toxic effects, safety in combining CAM and other modalities, likely acceptance by clients and the public, and ease of incorporation into traditional pain management practices.

The Journal of Rehabilitation Research and Development (JRRD) has been a leading research journal in the field of rehabilitation medicine and technology for over 40 years. Formerly the Bulletin of Prosthetics Research, JRRD debuted in 1983 to include cross-disciplinary findings in rehabilitation. JRRD, a scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines.

JRRD publishes in both print and electronic formats, increasing the journal's dissemination from a hard copy circulation of 8,000 to 2.3 million Web downloads in 2005. Currently, there are over 1,000 peer-reviewed articles available in electronic format and free for downloading. JRRD will initiate an archiving program in 2005 to make all issues of JRRD and the Bulletin of Prosthetics Research available online.

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Abstract from Michael H. Cohen, Legal and Ethical Issues in Integrative Pain Management, In: Integrative Pain Medicine: The Science and Practice of Complementary and Alternative Medicine in Pain Management (Audette, JF & Bailey A, editors). Totowa, NJ: Humana Press, 2007 -

Use of complementary and alternative medical (CAM) therapies (such as acupuncture and traditional oriental medicine, chiropractic, herbal medicine, massage therapy, and 'mind-body' therapies such as hypnotherapy and guided imagery) may be more common than in pain management as compared to other clinical specialties, because of medical recognition that pain has psychological (and perhaps even spiritual) as well as physical dimensions. Nonetheless, the integration of CAM therapies into pain management raises legal issues for clinicians who may be initiating delivery of CAM therapies, referring patients to CAM providers, or simply responding to patient requests concerning specific CAM modalities. This review addresses some of the key legal issues and liability risk management strategies that may be helpful in integrative pain management.
Keywords
Liability, medical malpractice, informed consent, complementary and alternative medicine, pain management.