Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it.

Dr. Mark Borigini is a board-certified rheumatologist who has devoted his career to treating, and training others to treat, a wide variety of illnesses that cause chronic pain and disability. See full bio

March 26, 2009, Health

Complementary Medicine: Seeking an Alternative to Chronic Pain

Tincture of frog's eye, please.

A recent release of survey data by the Centers for Disease Control and Prevention and the National Institutes of Health revealed that in 2007 approximately 38% of adults and almost 12% of children in these United States used some sort of complementary or alternative medicine.

The adults used complementary and alternative medicine (CAM) therapies mostly for the treatment of chronic pain, and often for the chronic pain related to back, neck or joint complaints.

But many rheumatologists feel there is a higher prevalence of CAM usage by those afflicted with chronic illnesses such as rheumatoid arthritis and osteoarthritis.

It is crucial that health care providers make the effort to ask their patients if they are indeed taking, for example, herbal supplements in addition to their prescription medications; this is because many patients do not consider these "medicines". However, herbal supplements have been known to result in blood and liver function abnormalities, potentially threatening the health and well-being of the patient---particularly if these are taken in addition to a patient's prescription medications.

But the subject of CAM must be approached with an open mind by the health care provider: many patients might purposely withhold information about CAM usage should they feel their doctors will scold them, or worse still, laugh at them. It is important for the physician to know if any closer laboratory monitoring is warranted

Considering the economic woes this country is now confronting, it is likely that the use of CAM is more prevalent than the aforementioned 2007 data suggest. With the loss of employment is in many cases the concomitant loss of health insurance; people will turn to CAM to ease their pain if they cannot afford the money for a visit to the doctor's office.

Unfortunately, CAM therapies are not regulated by the Food and Drug Administration, as even generic aspirin and Pepto-Bismol are regulated; CAM therapies are not considered "drugs", although they can have many of the same dangerous side effects drugs can have. And some of these side effects may be the result of impurities from a flawed manufacturing process.

The most commonly used CAM therapies are those "natural" products, such as fish oil, glucosamine, flaxseed oil, and ginseng. Other types of CAM therapy include chiropractic care, deep breathing methods, massage, and yoga.

CAM therapy efficacy is difficult to assess, as industry is generally not going to pay for expensive testing of commonly available supplements that will never be on patent. It would be nice to know if the supplements we buy are truly making a difference in the treatment of disease; and of similar importance, are these supplements harming us?