Complementary Health Approaches

Research on Pain Management

How Many Have Chronic Pain?

Chronic pain is pain that lasts a long time. It’s a very common problem. Results from the 2012 National Health Interview Survey show that

  • about 25.3 million U.S. adults (11.2 percent) had pain every day for the previous 3 months
  • nearly 40 million adults (17.6 percent) had severe pain
  • individuals with severe pain had worse health, used more health care, and had more disability than those with less severe pain.

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 and Aging

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. Some painful conditions, such as arthritis, become more common as people get older.

Use of Complementary Approaches

The use of complementary health approaches is common among adults with painful conditions. For example, in a national survey, 47 percent of people who had migraine or back pain with sciatica used complementary approaches, as did 41 percent of those who had headaches regularly.

The most common reasons why adults use complementary approaches are conditions that involve pain. Back pain is the number one reason why adults use complementary approaches, neck pain is second, and joint pain or stiffness is third, according to 2012 national survey data.

What the Research Shows

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

  • Low-back pain: Acupuncture, progressive relaxation, spinal manipulation, and yoga may be helpful.
  • Neck pain: Acupuncture and spinal manipulation may be helpful.
  • Osteoarthritis pain: Acupuncture, massage, and tai chi may be helpful.
  • Rheumatoid arthritis pain: Omega-3 fatty acids (fish oil) may help to a modest extent.
  • Headaches: Acupuncture may be helpful. According to the American Academy of Neurology and the American Headache Society, butterbur is effective for preventing migraines; feverfew, magnesium, and riboflavin are probably effective; and coenzyme Q10 is possibly effective.
  • Fibromyalgia: Some studies of tai chi, yoga, mindfulness meditation, and biofeedback have had promising results, but there isn’t enough evidence to be certain that any of these methods is helpful.

Pain Research at NIH

NIH (The National Institutes of Health) 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.

The National Center for Complementary and Integrative Health (NCCIH), 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. NIH-sponsored studies of back pain and neck pain indicated that massage therapy may be helpful for both of these problems.
  • Mindfulness-based stress reduction for low-back pain. An NIH-sponsored study found that both mindfulness-based stress reduction and cognitive-behavioral therapy (a type of conventional psychotherapy) were more effective than usual care for chronic low-back pain.
  • How mindfulness may help relieve pain. In an NIH-sponsored study, researchers found that the mechanism by which mindfulness meditation relieves pain is different from the mechanism by which opioid drugs achieve the same effect.
  • Spinal manipulation for neck pain and low-back . Either spinal manipulation therapy or home exercise instruction was more effective than medication for neck pain, according to an NIH-sponsored study. . Another study showed that a type of spinal manipulation commonly used by chiropractors was helpful in reducing pain and disability in people with acute or sub-acute low-back pain.
  • 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.

  • 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 followup study 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 followup study showed that tai chi classes were as helpful as physical therapy for knee osteoarthritis pain.

(Watch the video to see how tai chi is performed. Always check with your health care provider before starting an exercise program. See Safety First for more tips. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)

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.