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17.06.2014

Complementary alternative medicine for pain, cancer tutorials - Review

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Thirty-eight percent of Americans use some sort of complementary and alternative medicine (CAM) treatments to manage their chronic pain.
Despite improved research over the past decade, pain remains a major cause of disability in America. While tremendous progress has been made in drug treatment of acute pain, there are pressing needs for better understanding and better treatments for chronic pain. In spite of the widespread use of CAM therapies for chronic pain, scientific evidence on whether the therapies help the conditions for which they are used is, for the most part, limited.
Last year, NCCAM launched a new multidisciplinary pain program focusing on the role of the brain in perceiving, modifying, and managing pain.4 Catherine Bushnell, PhD, a pain and neuroscience researcher, was appointed scientific director of the new program, which will complement basic science and clinical research efforts of other National Institutes of Health (NIH) intramural programs in neuroscience, imaging, and mental and behavioral health.
Research projects will include investigating the role of the brain in pain processing and control, and how factors such as emotion, attention, environment, and genetics affect pain perception. In addition, NCCAM is supporting a yearlong Internet-based survey of people with chronic pain and other chronic conditions to study CAM effectiveness as well as interactions among stress and coping, pain, and treatment outcomes.
In light of the human and economic costs of chronic pain, as well as evidence that many people who suffer from chronic pain turn to CAM for relief, NCCAM places a high priority on pain-related research.
While building an evidence base to help people with chronic pain and their health care providers make decisions about specific therapies, CAM research is also helping close gaps in our basic understanding of pain mechanisms. Source: This article was written based on information provided by the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health. Reviews of research on acupuncture, massage, and spinal manipulation for chronic low back pain have found evidence that these therapies may be beneficial.
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This article describes the results of expanding psychological services for veterans being seen in an interdisciplinary pain management program to include 5 choices of complementary and alternative medicine (CAM) approaches at the Michael E.


Veterans reported substantial “improvements since last session” especially in pain and sense of well-being (73% and 74%, respectively). Monthly administration of a set of 4 brief, standardized assessment tools was used as a supplement to the session rating forms to assess and monitor progress on 4 outcome domains in addition to pain intensity: anxiety, depression, sleep quality, and sense of well being. Hypothesis 1 stated that CAM therapies would be acceptable to Veterans and feasible for clinicians to implement in a pain management program.
These findings indicate that the CAM therapies could be easily incorporated into a traditional pain management program. According to the Institute of Medicine, more than 100 million people in the United States suffer from chronic pain. The survey is called PROCAIM—Patient-Reported Outcomes from Complementary, Alternative, and Integrative Medicine. However, researchers in this area face unique challenges in that much remains to be understood about the nature of chronic pain and about the best approaches to studying its many different causes, people’s different responses, and the value of various treatment approaches—CAM and conventional. For example, researchers are using state-of-the-art imaging technology to see how acupuncture affects brain activity. Vertical Health Media, LLC disclaims any liability for damages resulting from the use of any product advertised herein and suggests that readers fully investigate the products and claims prior to purchasing. Incorporating Complementary and Alternative Medicine (CAM) Therapies to Expand Psychological Services to Veterans Suffering From Chronic Pain. Among the 5 CAM portable devices made available to the Veterans (the option of switching devices between sessions was permitted), a majority opted for the AS (73%), followed by 11% for the SE, 6% for the EW, 6% for the RR, and 4% for the AVS. This hypothesis was supported by results of informal retrospective review by clinicians of the ease of recruiting and enrollment (acceptability to Veterans), and ease of incorporating CAM therapies into the existing pain management program (feasibility). Perhaps the greatest potential benefits of the CAM therapies presented in this paper lies in the observation that the CES and the SE could potentially be used as a form of self management which could be combined with other psychological interventions such as CBT. The ultimate goal of chronic pain research is to build an evidence base that can guide pain management decisions tailored to individuals.


One study’s finding that demonstrated how changes in brain activity during acupuncture are different for people with chronic pain compared with healthy people is important for understanding not only how acupuncture might work but also pain processes in general. Reviews of research on other CAM therapies that people sometimes use for chronic low back pain, such as various herbal remedies and prolotherapy injections, generally have found limited or no evidence to support their use for this purpose, or the evidence is mixed.
Clinics are made available 3 times a week for an hour each on a drop-in-as-needed basis (without the need to make appointment) making it more convenient and accessible to the veterans. These decisions often involve combining treatment approaches in cost-effective ways that do the best possible job of helping people with chronic pain minimize pain, maximize function, and improve quality of life.
The cost for acquiring the CAM devices used currently ranges from $145 for SE to $450 for AS, which is affordable for many programs, especially when considered in light of the costs of other medical equipment and devices. For example, a single nerve block injection for low back pain typically costs around $600.00, including facility and professional charges.
Each veteran could choose from among the 5 CAM modalities and switch to another at any time, however, a large majority (73%) of veterans chose to use AS, followed by SE (11%) down to 4% for the David PAL.
The vets were asked to complete a self-monitoring form indicating self reported pain ratings and other benefits including sleep, anxiety, depression, and sense of well being before and after the session as well as similar benefits since the last session.
Hypothesis 3, which states that adding CAM therapies reduces pain intensity ratings and improves quality of life among participants, also received preliminary support by the findings.
Along with acceptability, results indicate that the CAM therapies used in the MEDVAMC program show promising levels of efficacy as an alternative or additional treatment modality in a group setting. For example, the reduction in reported pain intensity among the CAM participants as a group was modest but statistically significant, with a Cohen’s d of .93. In addition to pain reduction, Veterans who participated in the CAM therapies also reported improvements in a number of quality of life measures.



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