Loolwa Khazzoom: It seems that there is pressure to use pharmaceuticals to treat chronic pain, because there is more of an ability to point to a drug and say, “This has been proven to work.” Is there not the same level of research into the degree to which complementary and alternative medicine therapies work?
James Dillard, MD: There are literally thousands and thousands of clinical trials in acupuncture, mind-body medicine, nutritional interventions, manual therapies, and so on. There are also rigorous systematic reviews and meta-analyses of these kinds of treatments, as well as Cochrane consensus statements on them, so if someone says there isn’t data, it just means that person has not seen it.
In terms of the professional academy guidelines, there is generally not a consensus that these treatments work. Keep in mind that the professional associations are trade organizations, so they are focused on what they do. You can’t expect the association for orthopedic surgeons to put a lot of effort into exploring the mind-body connection, as they develop guidelines on how orthopedic surgeons should practice – for example, relative to neck and low back pain.
LK: What is the science behind energy healing – acupuncture, acupressure, qi gong, reiki and so on?
JD: We don’t know all the exact mechanisms of how these things work. Certainly, they are tremendously comforting. Any time you put your hands on somebody, and anytime you actually just help somebody, you’re comforting that person. Doing so probably has a very primitive effects on the mind. Some doctors would call that placebo, but I think it’s real therapy.
There is also a lot of overlap in treatments – whether massage, yoga, or Trager work. They all have aspects of mind-body connection, physical contact, spiritual healing, and energy healing. If you give someone a reiki treatment, you put your hands on him or her. You administer to that person. Is energy being transferred from the universe? I don’t know.
Remember, for thousands of years, really smart people, with IQs just as high as our IQs today, stood at the edge of the sea and looked out and said, “It’s flat. It’s definitely flat. There’s no question about it. We know it’s flat.” And guess what? It wasn’t flat. And they were just as smart as we are today. They might not have been as knowledgeable, but they were just as smart. So we have to always be a little cautious about how we think things work.
James N. Dillard, M.D., D.C., C.Ac., is one of the leading pain specialists in America and the author of numerous books on chronic pain, including The Chronic Pain Solution. His many media appearances have included The Oprah Winfrey Show, Good Morning America, and the CBS Evening News. He served as an assistant clinical professor at Columbia University College of Physicians and Surgeons for 12 years and also was the Medical Director of Columbia’s Rosenthal Center for Complementary and Alternative Medicine. He resigned from employment at Columbia in 2006, to go exclusively into private practice. He now writes a column for the East Hampton Star, “To Your Health.”