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      A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care

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          Abstract

          Introduction

          Non-pharmacologic alternative therapies for pain have been around for a long time, some for hundreds of years. They have been used throughout history to treat many issues.

          Recent Findings

          Currently, alternative medicine is most frequently used to treat musculoskeletal pain, and between 59 and 90% of patients utilizing alternative therapies for chronic pain claimed they were helpful and can serve as an effective adjunctive for the treatment of chronic pain. Some examples of alternative therapies that will be discussed in this review include acupuncture, tai chi, osteopathic manipulation, and chiropractic care. Acupuncture, traditionally a Chinese practice, is becoming more popular across the world to attempt to relieve pain. It involves the placement of thin needles at various points in the body. The efficacy of acupuncture for pain is heavily debated. More research and discussion are necessary to determine the exact role it plays in the treatment of chronic pain. Tai chi is also a traditional Chinese practice that is often used as a form of meditation and for potential health benefits. Tai chi involves a series of complex movements such as squatting combined with deep breathing to achieve relaxation and pain reduction. Osteopathic manipulative treatment (OMT) is a technique used by both osteopathic physicians (DO) as well as other health professionals to manage a wide range of conditions in any given patient. The technique involves utilization and manipulation of the musculoskeletal system to achieve potential health benefits. OMT has been used as therapy for many issues but is commonly used for pain conditions.

          Summary

          Alternative therapies may serve as an effective adjunctive treatment modality for the management of chronic pain conditions. There has been a tremendous amount of research dictating the effectiveness of alternative therapies for chronic pain management. The purpose of this review is to provide a comprehensive evidence-based update of alternative therapy used for the management of chronic pain conditions.

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          Most cited references55

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          Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.

          Chronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. Chronic pain has a weighted mean prevalence in adults of 20%.For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercise may have specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning.Physical activity and exercise programmes are increasingly being promoted and offered in various healthcare systems, and for a variety of chronic pain conditions. It is therefore important at this stage to establish the efficacy and safety of these programmes, and furthermore to address the critical factors that determine their success or failure.
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            Comprehension of Top 200 Prescribed Drugs in the US as a Resource for Pharmacy Teaching, Training and Practice

            Pharmacists have access to a plethora of information related to drugs. Online compendia concerning top 200 prescribed drugs are readily-accessible, comparatively-easy to search. While these resources provide some information about the commonly prescribed drugs, they lack in furnishing in-depth knowledge to pharmacy students, pharmacists and other healthcare professionals. The aim of this paper is to present the relevant details of top 200 most prescribed drugs in the United States. The names and therapeutic classes of top 200 prescribed drugs were compiled from online resources. The pharmacological actions of drugs, any reported adverse reactions and black box warnings are collected from drug bank resources, such as AccessPharmacy and Lexicomp. The paper provides comprehensive information about top 200 prescribed drugs, which includes generic names, pharmacological action, route of administration and adverse reaction profile including black box warning when applicable. Overall, the drug list may serve as an easy access of ideas for pharmacists, researchers and other healthcare professionals interested in developing new strategies for treating patients with various ailments.
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              Acupuncture for chronic pain: individual patient data meta-analysis.

              Although acupuncture is widely used for chronic pain, there remains considerable controversy as to its value. We aimed to determine the effect size of acupuncture for 4 chronic pain conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain. We conducted a systematic review to identify randomized controlled trials (RCTs) of acupuncture for chronic pain in which allocation concealment was determined unambiguously to be adequate. Individual patient data meta-analyses were conducted using data from 29 of 31 eligible RCTs, with a total of 17 922 patients analyzed. In the primary analysis, including all eligible RCTs, acupuncture was superior to both sham and no-acupuncture control for each pain condition (P < .001 for all comparisons). After exclusion of an outlying set of RCTs that strongly favored acupuncture, the effect sizes were similar across pain conditions. Patients receiving acupuncture had less pain, with scores that were 0.23 (95% CI, 0.13-0.33), 0.16 (95% CI, 0.07-0.25), and 0.15 (95% CI, 0.07-0.24) SDs lower than sham controls for back and neck pain, osteoarthritis, and chronic headache, respectively; the effect sizes in comparison to no-acupuncture controls were 0.55 (95% CI, 0.51-0.58), 0.57 (95% CI, 0.50-0.64), and 0.42 (95% CI, 0.37-0.46) SDs. These results were robust to a variety of sensitivity analyses, including those related to publication bias. Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture.
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                Author and article information

                Contributors
                ivanurits@gmail.com
                Journal
                Adv Ther
                Adv Ther
                Advances in Therapy
                Springer Healthcare (Cheshire )
                0741-238X
                1865-8652
                12 November 2020
                12 November 2020
                2021
                : 38
                : 1
                : 76-89
                Affiliations
                [1 ]Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
                [2 ]GRID grid.410396.9, ISNI 0000 0004 0430 4458, Department of Anesthesiology, , Mount Sinai Medical Center, ; Miami Beach, FL USA
                [3 ]GRID grid.134563.6, ISNI 0000 0001 2168 186X, University of Arizona College of Medicine-Phoenix, ; Phoenix, AZ USA
                [4 ]GRID grid.254748.8, ISNI 0000 0004 1936 8876, Creighton University School of Medicine, Phoenix Regional Campus, ; Phoenix, AZ USA
                [5 ]GRID grid.417468.8, ISNI 0000 0000 8875 6339, Department of Anesthesiology, , Mayo Clinic Arizona, ; Phoenix, AZ USA
                [6 ]GRID grid.279863.1, ISNI 0000 0000 8954 1233, Department of Anesthesiology, , Louisiana State University Health Sciences Center, ; New Orleans, LA USA
                [7 ]GRID grid.259828.c, ISNI 0000 0001 2189 3475, Department of Anesthesiology, , Medical University of South Carolina, ; Charleston, SC USA
                [8 ]GRID grid.134563.6, ISNI 0000 0001 2168 186X, Department of Anesthesiology, , University of Arizona College of Medicine-Phoenix, ; Phoenix, AZ USA
                [9 ]GRID grid.254748.8, ISNI 0000 0004 1936 8876, Department of Anesthesiology, , Creighton University School of Medicine, ; Omaha, NE USA
                [10 ]Valley Anesthesiology and Pain Consultants, Phoenix, AZ USA
                Article
                1554
                10.1007/s12325-020-01554-0
                7854390
                33184777
                e7b7f64d-db51-4e2c-9c9f-2d586f88392d
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 8 September 2020
                : 28 October 2020
                Categories
                Review
                Custom metadata
                © Springer Healthcare Ltd., part of Springer Nature 2021

                acupuncture,chiropractor,osteopathic manipulative treatment,pain,tai chi

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