Many patients suffering from chronic pain try alternative and complementary treatments as these are often viewed as natural and therefore risk-free.
Prof. Edzard Ernst (Exeter, UK) warned at the EFIC Congress 'Pain in Europe VII' that patients are being bombarded with misinformation on the subject but that in fact very few alternative pain treatments are supported by well-founded evidence. However, evidence was presented during the Congress that therapies, such as acupuncture, acupressure and aromatherapy are efficient in tackling pain.
Acupuncture after surgery: More than placebo
Acupuncture can work against acute pain, for instance after surgery. Findings of two review papers reveal that acupuncture applied at certain times following an operation actually achieves a moderate reduction in pain relief. According to Dr. Winfried Meissner (Jena, Germany):
"The same goes for ear acupuncture, whereby patients sometimes subjectively do not notice immediate pain reduction, but verifiably require fewer additional analgesics. A role is certainly played by nonspecific or placebo effects, as for example the presence of a therapist or the expectations of patients. However, our own studies show that acupuncture, even in patients under narcosis where no placebo effect can come into play, produces similar effects in the brain as pain relievers. That is a clear indication of a specific analgesic effect through acupuncture."
Complex placebo effects in acupuncture
A study that assessed the extent of the placebo effect in acupuncture studies opens up entirely new opportunities for research. Researchers discovered that the part of the placebo phenomena on the overall effect of acupuncture is potentially greater than the specific effect. Earlier studies also revealed placebo-acupuncture to be more effective than placebo-tablets, however, this raised the question of how placebo-acupuncture could be executed. Most studies treated patients in placebo control groups by inserting needles into parts of the body that were not acupuncture points (sham acupuncture), however, the actual inserting also produces physiological effects. Newer studies therefore started using non-penetrating telescopic blunt needles (placebo needles) for control purposes that produce the same piercing feeling as 'real' needle.
PD Dr. Konrad Streitberger (Bern, Switzerland) explained at the EFIC Congress:
"Studies using functional magnetic resonance imaging (fMRI) showed that real acupuncture not only causes stronger activation or deactivation response patterns than placebo treatment in pain associated areas of the brain, but also that this effect can be modulated by a positive expectation. This shows that different mechanisms are at work in acupuncture whose complex relationships we do not fully understand and that will still require extensive research."
Positive influence of acupressure in chronic neck pain
Acupressure, like acupuncture but without the use of needles works by applying finger pressure onto reflex points that lie directly within the area of pain or slightly outside. A new study presented by a Japanese research group revealed that both approaches, acupuncture as well as acupressure significantly reduced chronic neck pain. Treating reflex points in pain areas also achieves an additional positive influence on the autonomic nervous system as it lowers the heart rate and increases heart rate variability. Both are indicators of the organism's adaptability to changing external conditions.
Eucalyptus or lavender: effects on pain and inflammation
Certain essential aromatic oils have analgesic and anti-inflammatory properties. During the Congress, Korean scientists revealed their study results of the effect of rosemary, marjoram (oregano), lavender, eucalyptus and basil essential oils on mice. Depending on the kind of irritation, eucalyptus and lavender proved to be the strongest painkillers with eucalyptus proving to have even stronger analgesic effects compared to a similar dose of morphine. According to the scientists, an additional plus-point was that "eucalyptus oil was also analgesic when the mice were pre-treated with naloxone, an agent that cancels the analgesic effect of opioids in the body, whereas the effect of lavender and basil oil was blocked."
Written by Petra Rattue