Pain and CAM

Question 1

What is the NCCAM?

Answer 1

National Center for Complementary and Alternative Medicine - Federal Government’s lead agency for scientific research on health interventions, practices, products, and disciplines that originate from outside mainstream medicine

Question 2

T/F 38% of Americans report using some form of CAM therapy.

Answer 2

True

Question 3

T/F 38% of Americans report using some form of CAM therapy and 18% of Americans use natural supplements.

Answer 3

True

Question 4

What is the most common natural supplement used among adults?

Answer 4

Fish oil

Question 5

What are the advantages & disadvantages of allopathic treatment?

Answer 5

Advantages: trained doctors, fast treatment, immediate relief
Challenges: short term v. long term benefits
sometimes you don’t find the root cause

Question 6

What are the advantages & disadvantages to CAM?

Answer 6

Advantages: conservative, popular, maybe minimizes side effects of certain meds
Challenges: expensive, lack of training of, maybe don’t address root cause

Question 7

Is there evidence that CAM can ever help lower back pain?

Answer 7

Good evidence that cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation are all moderately effective for chronic or subacute (>4weeks’ duration) low backpain.
Fair evidence that acupuncture, massage, yoga, and functional restoration are also effective for chronic low backpain.

Question 8

Was spinal manipulation (chiropractric) superior to sham therapy in a meta-analysis?

Answer 8

yes

Question 9

Was spinal manipulation (chiropractric) superior to sham therapy in a meta-analysis?

Answer 9

yes, but more short-term benefit

Question 10

What is yoga helpful for?

Answer 10

hamstrings-tight
core muscles-weak
hip flexors–tight
stress relief

Question 11

What is yoga helpful for?

Answer 11

hamstrings-tight
core muscles-weak
hip flexors–tight
stress relief-reduction in cortisol even after one session

Question 12

What is devil’s claw?

Answer 12

treats pain, liver, kidney problems, fever, malaria, heals sores, boils, skin problems
anti-inflammatory–iridoid glycosides, harpagoside
**can cause GI upset, anti-platelet effects, hypoglycemia
shouldn’t use w/ HTN/CAD, pregnancy, gastritis/ulcers

Question 13

What’s the deal with willow bark?

Answer 13

anti-inflammatory & analgesic
sialcin (similar to ASA)
Side effects: GI upset, nephrotoxicity, tinnitus, anti-platelet
don’t use in pregnancy
can reduce levels of diuretics, dilantin, methotrexate

Question 14

What’s the deal with capscium?

Answer 14

from chili peppers
depletes Substance P
side effects: burning, GI upset, flushing, sweating
Don’t take w/ anti-platelet, theophylline, ACE inhibitors

Question 15

What’s the deal with glucosamine/chondroitin?

Answer 15

reduction in pain for osteoarthritis
sometimes only a little better than placebo
can’t take w/ shellfish allergy

Question 16

What is balneotherapy?

Answer 16

baths w/ thermal mineral water
mineral content 1g/L
20degrees Celsius
found in Eastern Europe, Middle East, India

Question 17

What are possible therapies for low back pain?

Answer 17

a) NSAID
b) Acetaminophen
c) Hydrocodone/acetaminophen
d) Tramadol
e) Cyclobenzaprine
f) Gabapentin
g) Devil’s Claw
h) Willow Bark
i) Capscium
j) Glucosamine/chondroitin
k) Ice/heat
l) Stretching/exercises
m) Interdisciplinary rehab/physical therapy
n) Accupunture
o) Yoga
p) Spinal Manipulation
q) Massage
r) Cognitive & Behavioral Therapy