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'Little evidence' for most complementary medicines in arthritis, finds review

There is a lack of evidence that complementary therapies such as glucosamine and copper bracelets help treat musculoskeletal conditions, and many therapies carry a risk of side effects, a report by an arthritis charity has found.

The evidence-based review, commissioned by Arthritis Research UK, found that most complementary therapies rated poorly for evidence of efficacy for rheumatoid arthritis, with only fish body oil scoring well and some evidence supporting the use of borage seed oil and evening primrose oil. Only four complementary products were assessed for efficacy in fibromyalgia and none were highly effective, the report found.

There was also concern about the safety of some complementary treatments, with treatments such as chiropractic, osteopathy and flaxseed oil being assigned ‘amber’ warnings for frequency of minor adverse effects.

The complementary therapies that were had the best evidence for efficacy included acupuncture for osteoarthritis, low back pain and fibromyalgia, massage for fibromyalgia and low back pain, tai chi for osteoarthritis and yoga for back pain.

In terms of supplements, capsaicin had the highest level of evidence for efficacy in osteoarthritis, while the nutritional supplement SAMe (S-adneosyl-methionine) was also found to be well tolerated and showed evidence for effectiveness in osteoarthritis.

Other therapies that showed modest evidence for efficacy in osteoarthritis included evening primrose oil, rose hip ginger and green-lipped mussel extract. There was mixed evidence for the efficacy of the widely-used supplement glucosamine in osteoarthritis, with the review noting that it had shown ‘little clinical benefit in terms of pain or changes in the joint’.

Professor Alan Silman, medical director of Arthritis Research UK, said the effectiveness of some complementary therapies in arthritic conditions was likely due to a placebo effect.

‘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,’ he said.

The report noted that up to 60% of people with musculoskeletal conditions in the UK use complementary therapies.

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