Complementary Health Approaches

Research on Pain Management

About 100 million U.S. adults suffer from chronic pain conditions. (Chronic pain is pain that lasts for a long time, usually at least several months.) The annual economic cost of chronic pain in the United States, including both treatment and lost productivity, has been estimated at approximately $600 billion.

Chronic pain is more common among women than men, and it becomes more common with increasing age. Experts expect the number of people with pain to increase, in part because the U.S. population is aging, and some painful conditions, such as arthritis, become more common as people get older.

The 2007 National Health Interview Survey showed that use of complementary health approaches was common among adults with painful conditions. For example, 47 percent of survey respondents who had migraine or back pain with sciatica used complementary approaches, as did 41 percent of those who had headaches regularly.

More adults used complementary health approaches for painful conditions than for any other type of health problem. Back pain was the number one reason why adults used complementary health approaches, and neck pain, joint pain/stiffness, arthritis, other musculoskeletal pain, and severe headache or migraine all ranked among the top 10.

What the Research Shows

Research has shown that some complementary health approaches may help people with some types of pain. Here are some examples of complementary approaches that may be helpful for certain conditions.

  • Acupuncture, massage, progressive relaxation, spinal manipulation, and yoga may be helpful for low-back pain.
  • For neck pain, acupuncture and spinal manipulation may be helpful; whether massage helps is uncertain.
  • Acupuncture, massage, and tai chi may be helpful for osteoarthritis pain.
  • For rheumatoid arthritis pain, omega-3 fatty acids (fish oil) may help to a modest extent.
  • Acupuncture, relaxation techniques, and spinal manipulation may be helpful for reducing the frequency of headaches.
  • Research on complementary approaches for fibromyalgia is in its early stages, but there is some evidence that massage, tai chi, and meditation might help.

Pain Research at NIH

Pain is an important focus of NIH research.

NIH has established a Pain Consortium to enhance research on pain and promote collaboration among researchers from the many NIH agencies that have programs and activities related to pain.

NCCAM, which is NIH’s lead agency for complementary health approaches, is part of the consortium and is working to improve the evidence on the effectiveness and safety of complementary approaches for pain. In addition, NCCAM has a research program that focuses on the role of the brain in perceiving, modifying, and managing pain.

NIH-sponsored Research on Complementary Health Approaches for Pain

Examples of NIH-sponsored research on complementary health approaches for pain include the following.

  • Yoga for low-back pain. Two NIH-sponsored studies showed that participating in yoga classes may be helpful in reducing symptoms of low-back pain.
  • Massage therapy for back or neck pain. Separate studies of back pain and neck pain indicated that massage therapy may be helpful for both of these problems.
  • Spinal manipulation for neck pain. Either spinal manipulation therapy or home exercise instruction was more effective than medication for neck pain, according to an NIH-sponsored study.
  • Acupuncture for pain. A group of researchers supported by NIH analyzed data from 29 studies of acupuncture for various types of pain (back and neck pain, osteoarthritis, shoulder pain, or headache). They found that when acupuncture was compared with simulated (fake) acupuncture, true acupuncture was more effective, but the difference in the pain relief produced by the two procedures was small. When acupuncture was compared with no acupuncture, a larger difference was seen.
  • How acupuncture may affect the brain during the treatment of pain. Several NIH-supported studies have investigated how acupuncture may affect the brain in people with pain. For example, a study in women with fibromyalgia found differences in the brain’s responses to acupuncture and simulated (fake) acupuncture. A study currently in progress is examining the brain responses to acupuncture and simulated acupuncture in people with painful osteoarthritis of the knee.
  • Tai chi for fibromyalgia and knee osteoarthritis. A preliminary NIH-supported study indicated that tai chi may help to relieve symptoms of fibromyalgia. A larger study now in progress is comparing the effects of tai chi to those of aerobic exercise in people with fibromyalgia. Another preliminary study showed that tai chi may be helpful for pain in knee osteoarthritis. A follow up study is comparing tai chi to physical therapy in people with knee osteoarthritis.

For More Information

You can find more information about complementary health approaches for pain on the Web site of the National Center for Complementary and Integrative Health (NCCIH) Another NIH agency, the National Institute of Neurological Disorders and Stroke, also has information on the treatment of pain, including the use of complementary health approaches.