EASTERN TREATMENTS
- 1. EasternTreatments for Fibromyalgia: Making Sense of the Data Scott D. Mist, PhD, LAc
- 2. Full Disclosure I am a licensed acupuncturist Some of what I tell you is personal opinion but I will try to between things that are supported by data and opinion
- 3. Overview What do I mean by Eastern treatments? What is the evidence? What does a common course of treatment look like? How to select a practitioner?
- 4. What do I mean by Eastern treatments? Diet Lifestyle Meditation Exercise such as tai chi, yoga, qigong, and nejang Herbal Medicine ExternalTherapies Acupuncture Massage such as tuina, shiatsu, and kunye Cupping
- 5. State of Published Evidence Diet Generally poor evidence due to lack of studies Few studies of fibromyalgia patients without additional diseases Interesting study by Holton, et al at OHSU found that MSG worsened fibromyalgia severity in patients with irritable bowel syndrome Holton KF, Taren DL, Tomson CA, Bennett RM & Jones KD 2012
- 6. State of Published Evidence Lifestyle Meditation More evidence than for diet but still not much Mostly focuses on mindfulness Improves quality of life, symptom severity but not pain Exercise1 Much more evidence but covered by Ms. Ferdig’ presentation 1 Mist SD, Firestone KA, Jones KD 2013
- 7. State of Published Evidence Herbal Medicine Huge field with very little research Several Chinese medicine formulas have been evaluated but study quality is low and none have been replicated Topical capsaicin has been shown to improve sleep disturbances and tenderness but not pain.
- 8. State of Published Evidence ExternalTherapies •Acupuncture
- 9. State of Published Evidence ExternalTherapies Acupuncture Many more studies! But conflicting information. Great Britain, Germany, Canada and Israel all include acupuncture among the highest level of evidence and suggest it be used depending on the individual’s interest. Wait a minute. It isn’t better than placebo?
- 10. State of Published Evidence ExternalTherapies Cupping Interesting but small study showed that fibromyalgia patients improved on pain and tender point count with cupping Massage Recent review showed that massage for greater than 5 weeks improved pain, anxiety and depression.1 1 Yan-hui Li, Feng-yun Wang, Chun-qing Fen, Xia-feng Yang, Yi-hua Sun 2014
- 11. What does a common course of treatment look like? Exercise • E.B. gave recommendations for exercise Acupuncture Best if twice a week for 4-6 weeks followed by weekly treatments to 20 treatment If you don’t get improvements in the first 6 weeks you may be a non- responder Often see sleep improve first
- 12. What does a common course of treatment look like? Massage Best if twice a week for 2-4 weeks followed by weekly for additional 4 weeks Should see improvements in first 4 treatments Meditation Only works if you practice Recommend that you find a good instructor in the beginning Changes happen in the first 4 weeks but may take as long as 12 There are many different types of meditation
- 13. Cupping CAVEAT – few studies and little best practices Best if weekly for 6 -8 weeks Should see improvements in first 4 treatments Warning, will leave bruises
- 14. How to select a practitioner First ask your friends! Second, look at national and state licensing agencies If you are looking for a Chinese herbalist, go to NCCAOM website.
- 15. Conclusions & Future Directions Eastern practices and therapies are promising and should be considered for adjunctive therapies A lot more research is needed in all areas of CAM and fibromyalgia