Guest Blogger: Bronia Michejenko, RN, MSN, GNP, BC

I have a small cabin on Toledo Bend  in East Texas.  Australian Pete, a gnarly 88 year old, lives two cabins down from me with three old dogs.  Australian Pete has lived in the US for over 60 years but still has his Australian accent.  He works as a helper for home construction projects.  I stopped by over Thanksgiving and he told me that there are times when he is “all stoved up.” He has seen his health care provider and has not found much relief for his chronic aches and pains.  He is looking at alternative therapies.

Millions of older Americans suffer from pain that is chronic, severe, and not easily managed. Pain from arthritis, back problems, other musculoskeletal conditions.  Many are turning to complimentary or alternative medicine (CAM) therapies. A recent survey showed that  40 percent of Americans age 18 or older reported using some form of complementary health practice and people age 50 or older were among the most likely to report use. Rigorous, well-designed clinical trials for many CAM therapies are often lacking; and the safety and effectiveness are uncertain. The National Center for Complimentary and alternative Medicine (NCCAM) is sponsoring research designed to fill this knowledge gap by building a scientific evidence base about CAM therapies – whether they are safe and whether they work for the conditions for which people use them.

Safety should be considered by patients before using complementary health products and practices. Our elderly patients should be encouraged to discuss the use of CAM with their health care provider to determine safety and effectiveness and to  choose carefully when selecting a CAM provider

The National Center for Complementary and Alternative Medicine published a guide using scientific evidence to help clarify what may be effective and what has been shown to have no effect on chronic pain.  I have included two common conditions from the chart in the table below.

In general, there is not enough scientific evidence to prove that any complementary health practices are effective for rheumatoid arthritis, and there are safety concerns about some practices.

Scientific Evidence on Complementary Health
for Pain

Some Evidence of Potential Benefit

Conflicting, or
No Evidence of

To Treat Low-Back Pain





Spinal Manipulation


Progressive Relaxation




To Treat Arthritis





Gamma Linolenic Acid (GLA)


Herbal Remedies


Tai Chi


For further information visit the NCCAM Web site at

For the complete chart from above see


  1. Lee M., Shin B, Ernst. E. Acupuncture for rheumatoid arthritis: a systematic review. Rheumatology. 2008, Dec, 47, 12, 1747-53.
  2. White P, Bishop F, Prescott P, Scott C, Little P, Lewith G. Practice practitioner or placebo? A  multifactorial mixed methods randomized controlled trial of acupuncture.  Pain. 2012, Feb, 153, 2, 455-62.
  3. Morone N, Greco C, Rollman B, Moore C, Lane B, Morrow L, Glynn N, Delaney J, Albert S, Weiner D. The design and methods of the aging successfully with pain study.  Contemp Clin Trials. 2012, Mar, 33, 2, 417-25.

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