Alternative & Integrative Health Archive

Ask the doctors

Q. I have uterine fibroids and am experiencing some pain and discomfort from them. Are there any alternative treatments that I can use to help manage my symptoms?

A. If you are experiencing anemia, severe pain, or difficulty with urinating that may be due to fibroids, it's important to seek the advice of a doctor. However, there are some pain management options other than medications or surgery that may help relieve symptoms related to fibroids. These strategies haven't been proven to relieve pain from fibroids, but The National Center for Complementary and Integrative Health, in a 2017 review of complementary approaches to chronic pain, found they have some promise in helping other types of chronic pain, specifically lower back pain. These include acupuncture, an alternative medicine treatment that uses small needles applied at specific sites on the body to relieve chronic pain; yoga, a type of low-impact exercise that includes a series of postures and breathing techniques; relaxation techniques, such as deep breathing and mindfulness (a practice that encourages staying focused on the present moment); tai chi, originally practiced as a form of self-defense, which incorporates slow, deliberate movements and deep breathing exercises; and massage performed by a massage therapist.

News briefs

A large study published online Nov. 4, 2019, by JAMA Internal Medicine offers hope for people who want to reduce their reliance on opioids. The powerful prescription painkillers, such as oxycodone (OxyContin) and hydrocodone (Vicodin), are typically used to treat severe pain after surgery, pain with terminal illness, and chronic pain. But use of these drugs comes with the risk of dependence, addiction, overdose, and death. So researchers set out to determine if mind-body therapies (such as meditation or hypnosis) could help ease pain. Scientists reviewed 60 randomized trials with more than 6,400 people taking opioids for reasons such as surgery, burns, cancer, or chronic pain. Researchers noted moderate to large improvements in pain among people who added meditation, hypnosis, cognitive behavioral therapy (CBT), or therapeutic suggestion to their pain control regimens. Meditation, hypnosis, and CBT were so effective that people were able to slightly reduce the amount of opioids they were taking. Two other therapies — relaxation therapy and guided imagery — did not have a significant impact on pain. The great news: you have nothing to lose by adding one of these mind-body therapies to your regimen, and it may even help.

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The extract from the cannabis plant is the hot new treatment for all kinds of ailments, but don't buy into it just yet.

Cannabidiol (CBD), extracted from the cannabis or hemp plant, has been promoted as the latest miracle cure for everything from aches and pains to anxiety and sleep disorders. There is a good chance you've heard a friend share his or her story about the wonders of CBD.

But is it miraculous — or just a mirage?

"CBD is being used over the counter in a range of ways that is not supported by the science," says Dr. Jordan Tishler, instructor of medicine at Harvard Medical School and president of the Association of Cannabis Specialists. "There is still much we don't know. But aggressive marketing, hype, and word of mouth have made CBD like a drug version of the emperor's new clothes. Everyone says it works, but lab studies suggest that it's really not what people think."

News briefs

Many people use psychological techniques to help them cope with chronic pain. But which approach is best? A study published Jan. 31, 2019, in the journal Evidence-Based Mental Health offers insight. Researchers analyzed 21 randomized studies focusing on the effect of either cognitive behavioral therapy (CBT), to redirect pain-related thoughts and behaviors, or mindfulness-based stress reduction (MBSR), combining yoga and meditation to build awareness and acceptance of moment-to-moment experiences (including pain). The result: There was no clear winner. Both approaches reduced pain and depression and improved physical functioning compared with usual care or no care. The authors say the findings are important, since CBT is considered the go-to psychological technique for chronic pain. But MBSR should be considered as an additional tool, they suggest. Want to try it? Many hospitals, universities, and meditation centers offer MBSR programs. You can also search for MBSR videos and classes online.

Sales of cannabidiol-infused products are expected to top $2 billion by 2021. But is CBD right for you?

Cannabidiol (CBD) is touted as a natural wonder that can help treat symptoms of everything from anxiety to arthritis pain. The plant extract comes from two varieties of cannabis — hemp and marijuana — and is available in creams, tinctures, oils, patches, gummy bears, capsules, and more. You can even add CBD to a latte if you walk into a coffee shop in some cities.

But is CBD safe for older adults? There haven't been a lot of large studies of CBD's safety, but more traditional medicines for pain and anxiety are not free of adverse effects, either. "I think CBD is likely safer than many other treatments people use for pain, insomnia, or anxiety," says Dr. Peter Grinspoon, a primary care physician with Harvard-affiliated Massachusetts General Hospital. Other physicians don't think we know enough about the safety profile of CBD to be sure.