Synthesizing the Strength of the Evidence of Complementary and Integrative Health Therapies for Pain.
Study Goal
The researchers aimed to synthesize the strength of evidence for therapeutic massage as a nonpharmacological option for pain management, comparing it with other CIH therapies.
Results Summary
The study found that massage has statistically significant positive effects on some types of pain, though firm conclusions for many pain types are limited by methodological issues or lack of RCTs. Individual studies suggest massage may be promising for multiple types of chronic pain.
Population
Not specified (general pain populations, likely including chronic pain and headache).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
acupuncture | decrease | pain | patients with headache and chronic pain | - | strongest evidence | #1 |
mindfulness techniques | decrease | some types of pain | - | - | statistically significant positive effects | #2 |
therapeutic massage | decrease | some types of pain | - | - | statistically significant positive effects | #3 |
tai chi | decrease | some types of pain | - | - | statistically significant positive effects | #4 |
tai chi | decrease | multiple types of chronic pain | - | - | may be promising | #5 |
mindfulness | decrease | multiple types of chronic pain | - | - | may be promising | #6 |
massage | decrease | multiple types of chronic pain | - | - | may be promising | #7 |
OBJECTIVE: Pain and opioid use are highly prevalent, leading for calls to include nonpharmacological options in pain management, including complementary and integrative health (CIH) therapies. More than 2,000 randomized controlled trials (RCTs) and many systematic reviews have been conducted on CIH therapies, making it difficult to easily understand what type of CIH therapy might be effective for what type of pain. Here we synthesize the strength of the evidence for four types of CIH therapies on pain: acupuncture, therapeutic massage, mindfulness techniques, and tai chi. DESIGN: We conducted searches of English-language systematic reviews and RCTs in 11 electronic databases and previously published reviews for each type of CIH. To synthesize that large body of literature, we then created an "evidence map," or a visual display, of the literature size and broad estimates of effectiveness for pain. RESULTS: Many systematic reviews met our inclusion criteria: acupuncture (86), massage (38), mindfulness techniques (11), and tai chi (21). The evidence for acupuncture was strongest, and largest for headache and chronic pain. Mindfulness, massage, and tai chi have statistically significant positive effects on some types of pain. However, firm conclusions cannot be drawn for many types of pain due to methodological limitations or lack of RCTs. CONCLUSIONS: There is sufficient strength of evidence for acupuncture for various types of pain. Individual studies indicate that tai chi, mindfulness, and massage may be promising for multiple types of chronic pain. Additional sufficiently powered RCTs are warranted to indicate tai chi, mindfulness, and massage for other types of pain.