Doubts over complementary therapies for arthritis

9th January 2013 - A lack of scientific evidence underpins the use of complementary therapies in treating arthritis, a study finds.

Around four out of 10 people in the UK use complementary medicine at some point in their lives. Those with arthritis and musculoskeletal conditions are particularly attracted to these therapies, with six out of 10 trying them.

A report by the medical charity Arthritis Research UK into the evidence behind a large number of complementary therapies has found a mixed picture, with some therapies being effective for certain conditions only, but some commonly used therapies lacked any scientific justification.

Lack of clinical evidence

Furthermore, the report shows that some of these treatments have not been subjected to any clinical trials or have been tested in only a single study.

On the positive side, the therapies shown to be the most effective are:

• Acupuncture for osteoarthritis, lower back pain and fibromyalgia
• Massage for fibromyalgia and low back pain
• Tai chi for osteoarthritis
• Yoga for back pain

However, little evidence was shown for popular therapies such as wearing copper bracelets or the use of magnets.

"The report aims to help people with musculoskeletal conditions and healthcare professionals by providing clear, scientific evidence about the safety and effectiveness of complementary therapies," says Professor Alan Silman, medical director of Arthritis Research UK in a statement.

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.

Therapies were judged to be effective according to improvements in pain, disability or quality of life. In addition the safety of each therapy was graded either green, amber or red.

Rheumatoid arthritis: Therapies used to treat rheumatoid arthritis scored poorly. 12 out of 17 complementary medicines scored just one - meaning there was little or no evidence of their effectiveness. However, fish body oil scored a maximum five for effectiveness, which suggests that it offers real benefits. It also received a green light for safety.

Osteoarthritis: Complementary therapies were more promising for people with this condition, with only four out of 22 scoring the lowest one point. One of the most popular products, glucosamine, was found to have mixed results in a number of trials. The report concludes there is little clinical benefit in terms of pain or changes in the joint. Glucosamine sulphate scored two points and glucosamine hydrochloride scored one point. At the other end of the scale, the nutritional supplement SAMe was found to be well tolerated and scored four points for effectiveness. Capsaicin, made from chilli peppers, proved the most effective for osteoarthritis, scoring the full five points. All therapies scored green for safety, with the exception of chiropractic which has an amber rating.

Fibromyalgia: Only four products were assessed for treating fibromyalgia and none of these were found to be highly effective. Three scored just two points and the fourth only one point.

A spokeswoman for the Complementary and Natural Healthcare Council (CNHC) tells us that "if people are looking to use complementary therapies then they should choose someone who is registered with the CNHC," although it says it does not comment on individual therapies for conditions.