Some people would say that evidence-based and CAM can’t go in the same sentence, but there have been a fair number of studies on complimentary alternative medicine or CAM. I think that it’s important for people to know that there are effective therapies from the CAM toolbox, and I would group them into bridging CAM and active CAM. I think they both have a place in helping a patient with pain move toward a more independent full life.
The bridging therapies could be things like spinal manipulation, acupuncture, massage. All of those while they’re being continuously reapplied are mildly to moderately effective at least as much as most of our therapies and often times more effective than opioids for chronic pain patients.The problem is once those are stopped, the repetitive application, the effect in terms of pain wears off.
There are another group of therapies that I’m calling active CAM as opposed to bridging CAM and they involve helping patients learn new life skills that have been proven to be effective. They include things like the Alexander technique, which is probably our most evidence-based, having coming out of the UK 100 years ago. Other modalities would include things like yoga, tai chi, Pilates, and similar mindful movement therapies that incorporate movement with other lifestyle changes.
I think there are a wide variety of patient types that might pick any number of these different complementary therapies. They are not as familiar to some of our Western ears and sensibilities but I think with our melting pot, they are becoming more and more acceptable and more available as well.