Complementary Therapies for Pain Management: An Evidence-based Approach

Elsevier Health Sciences, Jan 1, 2007 - 349 páginas
Pain is the single most common reason for patients to consult a CAM practitioner. This essential new book provides concise evidence-based information on complementary and alternative medicine (CAM) in relation to pain. Each section has a clear and accessible design to enable quick decision-making, and includes an analysis of the most up-to-date research available. Provides a single authoritative reference source on CAM for pain for healthcare professionals Takes a systematic and evidence-based approach Offers concise information on CAM diagnostic methods and treatments for pain Summarises clinical trial data on the effectiveness of CAM for specific areas of pain Alerts readers to areas where CAM may present risks Weighs the benefits and risks of each CAM treatment in relation to pain Includes CD-ROM for easy searching of the text

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Complementary Therapies for Pain Management:
An Evidence-Based Approach
Editors: Edzard Ernst, Max Pittler and Barbara Wider
Publisher: Mosby Ltd.
ISBN: 978-0-7234-3400-9
Some things in life have to be taken as inevitable, whether you like it or not. In the film Meet Joe Black with Brad Pitt and Anthony Hopkins, the characters learn that ‘Death and Taxes’ are as true to life as night follows day. That’s the way it goes. What wasn’t considered in the film was ‘Regulation’, but maybe that’s reserved for those who’ve chosen careers as clinicians within Complementary and Alternative Medicine (CAM).
The textbook Complementary Therapies for Pain Management: An Evidence-Based Approach was written to provide those who come from a more orthodox background with some answers to fundamental questions. Does herbal medicine help with migraine? Can osteopaths really affect the natural course of sciatica or mechanical back pain? Can someone suffering burn pain hope to obtain benefit from using hypnotherapy instead of sedatives and analgesics? To provide answers there needs to be several things in place. Firstly you need to have a clear definition of what the specific therapy does, the physiology that underpins its effects, and evidence of success (assuming that it does have some positive benefit over placebo).
The editors of this text make their position clear and have invited experienced clinicians within their respective fields to define their given therapy whether it be Feldenkrais Therapy, Naturopathy, Medical Herbalism, Craniosacral Therapy, or Music Therapy and Yoga. All subjects are defined with descriptions of the scientific rationale behind each therapy, together with the professional training and contexts when each therapy may be useful. The broad base of clinical evidence available is gathered from recent published and peer reviewed studies and deductions made directly from this data. If you have no evidence and don’t have a means to verify your chosen therapy’s scope for practice, then perhaps you need to re-evaluate your practice. This is certainly one of the criticisms made by orthodox practitioners over their CAM colleagues.
Janine Leach contributed the section on Osteopathy, and uses the opportunity to discuss where osteopathic models of diagnosis and treatment are distinctly at variance over traditional orthodoxy. She covers topics such as somatic dysfunction and segmental facilitation and cites the work of Denslow, Korr and Willard, putting those into context with both fluidity and balance.
Reading over her contribution revisits the persistent problem of reliable measurement of values within manual medicine. Some suggest the issue of accuracy of measurement, which current technology is incapable of accurately resolving, will remain osteopathy’s Achilles heel. Consider the implications if an MRI-like diagnostic unit, which could measure the hypothetical cranial rhythm? The importance of recognising that osteopathic treatment incorporates manual dexterity of a wide variety is acknowledged, as is the importance of the body’s innate ability for self-regulation, which seems to be disregarded or minimised by ‘corporate’ science. Conventional treatment using pharmacology to suppress the inflammatory index is the standard model. This bypasses the body’s powers of regeneration in the short-term, at the expense of the long-term. This approach is particularly seen in dealing with complex chronic pain conditions, and it is those very problems that form the basis of most osteopathic practice.
Sections One and Two cover how the authors propose the material in their text to be used; an overview on CAM; some general topics including epidemiology and the measurement of pain. Having talked to one of the editors, the subject of pain and its significance was seen to be an essential ingredient requiring examination. As a result, some interesting observations on pain are illustrated, including racial and age variations in pain perception. There is also an intriguing suggestion that


General topics
The epidemiology of pain
Current medical concepts of pain
Alternative concepts of pain
Concepts of pain in spiritual healing
Naturopathic concepts of pain
Osteopathic concepts of pain
Evening primrose Oenothera biennis
Lavender Lavandula angustifolia
1 Other herbal and nonherbal
Burn pain
33 Examples of other occasionally
Alexander technique

Concepts of pain in traditional

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