Complementary and Alternative Medicine Approaches for Pediatric Pain: A Review of the State‐of‐the‐science

Abstract

In recent years, the use of complementary and alternative medicine (CAM) in pediatric populations has increased considerably, especially for chronic conditions such as cancer, rheumatoid arthritis and cystic fibrosis in which pain may be a significant problem. Despite the growing popularity of CAM approaches for pediatric pain, questions regarding the efficacy of these interventions remain. This review critically evaluates the existing empirical evidence for the efficacy of CAM interventions for pain symptoms in children. CAM modalities that possess a published literature, including controlled trials and/or multiple baseline studies, that focused on either chronic or acute, procedural pain were included in this review. The efficacy of the CAM interventions was evaluated according to the framework developed by the American Psychological Association (APA) Division 12 Task Force on Promotion and Dissemination of Psychological Procedures. According to these criteria, only one CAM approach reviewed herein (self-hypnosis/guided imagery/relaxation for recurrent pediatric headache) qualified as an empirically supported therapy (EST), although many may be considered possibly efficacious or promising treatments for pediatric pain. Several methodological limitations of the existing literature on CAM interventions for pain problems in children are highlighted and future avenues for research are outlined.

Complementary and Conventional Medicine Use Among Youth With Recurrent Headaches

“…[46][47][48][49] The efficacy of acupuncture, thermal biofeedback, and hypnosis for children with HA has been documented. 50 However, little is known about the extent of the use of these types of CAM therapies among youth experiencing HA. We especially lack population-based prevalence estimates on the use of CAM among youth with HA and knowledge regarding associations with co-occurring chronic conditions that may also impact HA symptoms, functioning, and treatment response.…”

“…For instance, greater use among youth living in higher income households with private sector health insurance may be presumed to be due to the financial access these youth enjoy. To the extent that CAM has been demonstrated to be helpful for HA (eg, relaxation and mindfulness practices that relieve pain and stress, thermal biofeedback, acupuncture, hypnosis), 50 this disparity in access may further disadvantage minority and impoverished youth. Low rates of those modalities with the greatest evidence of benefit among all youth with HA may suggest a potential underuse of CAM modalities overall (eg, some mindbody therapies).…”

“…Although notable gaps exist, important evidence supports the use of many types of CAM for treating HA, including some of the modalities used by youth with HA, such as special diets, dietary supplements, herbs, and deep-breathing practices. 39,50 These findings have especially important implications for conventional care providers who care for the nation' s 11.2 million children with chronic conditions and special health care needs that national surveillance data have routinely shown most often experience multiple co-occurring conditions. In this study, we find that nearly all children experiencing HA have other chronic conditions, especially if they also use CAM (94%) and that youth across the range of other chronic conditions who also experience HA are significantly more likely to use CAM compared with children with these same types of conditions who do not experience HA.…”

A Review of Intravenous Lidocaine Infusion Therapy for Paediatric Acute and Chronic Pain Management

“…Non-pharmacological techniques are an extremely useful component of multimodal therapy [103][104][105]; unfortunately, they are under-utilised in hospitalised children [106]. The mainstay of acute pain management for children and youths resides in the use of opioid analgesia, but opioid use is associated with a significant side effect profile (see Table 2).…”

Anti-inflammatory Activity of Traditionally Important Insulin Plant Costus Species for the Treatment of Inflammation in Human

“…Herbal remedies and alternative medicines are used throughout the world and in the past herbs often represented the original sources of most drugs (Cooper, 2004). The plant kingdom has provided an endless source of medicinal plants first used in their crude forms as herbal teas, syrups, infusions, ointments, liniments and powders (Tsao and Zeltzer, 2005).…”