A report into the effectiveness of the complementary therapies that are commonly used for treating arthritis and other musculoskeletal conditions has found there is a lack of scientific evidence to support their use.
The report, launched by medical research charity Arthritis Research UK has revealed that many of the therapies have not been subjected to a clinical trial or may have only been tested in a single study.
The evidence-based report used results from randomised clinical trials to assess their effectiveness and safety. The findings present a mixed picture; while some therapies are effective for some conditions, this is not true for all.
The therapies that were shown to be the most effective by the study were:
Acupuncture for osteoarthritis, low back pain and fibromyalgia
Massage for fibromyalgia and low back pain
Tai chi for osteoarthritis
Yoga for back pain
There was little evidence in support of commonly-used therapies such as copper and magnetic therapy for any musculoskeletal disorder.
Professor Alan Silman, medical director of Arthritis Research UK, said:
“Complementary therapies are largely chosen by the patient and quite often paid for by the patient, and the relationship between patient and practitioner seems to be crucial in the effectiveness of the treatment.
"As a research organisation, apart from undertaking research about the value of individual therapies, we wish to focus on how this relationship, which may be part of the placebo effect, can help to give patient benefit.”
Twenty-five therapies were considered in the report. Each therapy was scored according to their effectiveness on a scale of one (little or no evidence that it was effective) to five (good evidence that it was effective), based on published data from clinical trials.
Effectiveness was measured in terms of improvements in pain, disability or quality of life. In addition the safety of each therapy was graded either green, amber or red.
Very little research has been conducted for therapies claiming to alleviate the symptoms of rheumatoid arthritis. The report examined 24 trials across nine therapies. Only a little evidence suggested biofeedback, relaxation therapy and tai chi are effective, each scoring two. The other six therapies scored one.
Fourteen different therapies were the subject of 53 trials, with 12 therapies scoring one or two. Evidence was much stronger in support of tai chi and acupuncture, which scored four and five respectively. All therapies scored green for safety except chiropractic, which has an amber rating.
Fifty trials examined 17 different therapies and 13 of the therapies scored either one or two. There was some promising evidence to suggest that tai chi and relaxation therapy may be effective, both scoring three. Acupuncture and massage were rated even higher, with scores of four or five, respectively.
Low back pain
Low back pain was the most studied of the four conditions, with 75 trials across 14 therapies. Eight therapies scored only one or two. Evidence for Alexander technique, osteopathy and relaxation was promising, scoring three. There was also good evidence in support of acupuncture and yoga, which scored four and five.
See the full report here.
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Make sure you have two-way communication. It's important that you and the person with arthritis discuss how you're both feeling. You need to agree how to work together so that they'll feel able to ask if they need extra help, and to turn it down if they don't.
Offer support and reassurance. The person in your care needs to feel supported and may also need reassurance that you don't resent the responsibility falling on you.
Understand the role of drugs. They're one of the main treatments for reducing the effects of arthritis symptoms. If you learn how each drug works you can understand how effective they'll be.
Encourage exercise. It's important for a person with arthritis to keep their joints moving to minimise pain and stiffness.
Understand the role of therapies.
Support the person in your care in applying for any benefits they may be entitled to.
Remember that you have needs too; caring can be hard work. You may want to try contacting a support group or get advice from <a href="http://www.carersuk.org/" target="_hplink">Carers UK</a>.