Tai chi may offer relief from back pain

The most common reason for using nontraditional medicine is back pain. Annually, 30 percent of the U.S. population experiences back pain severe enough to require medical therapy. Approximately 60 percent of the population uses some form of nontraditional medicine to relieve their pain. This makes nontraditional medicine the most common form of medical therapy used for back pain.

A significant number of people who experience back pain will heal with a very simple approach consisting of rest and pain medication. All back pain is not the same, however. It may be that persistent relief can be found in both traditional and nontraditional medicine.

A number of years ago, it was hypothesized that people who used nontraditional therapies for back pain did not believe in traditional medicine. Conversely, those who believed in traditional medicine did not use nontraditional treatments. A recent national survey demonstrates that it is not that simple.

Published in the Journal of the American Board of Family Medicine, the results of the 2002 National Health Interview Survey showed a more complex picture with regard to traditional and nontraditional medicine. In this study, the most common nontraditional therapy used was chiropractic manipulation followed by massage, herbal therapies yoga, tai chi and finally acupuncture.

As far as perceived benefits by patients, chiropractic methods were first. Massage, yoga, tai chi and qi gong tied for second with acupuncture coming in third. However, the differences between the various methods were very small.

What was interesting is that 53 percent of the respondents used traditional medicine and nontraditional medicine together suggesting a perception that both forms of medicine were beneficial and could easily be integrated.

Unfortunately, the study did not address some very important pieces of information, such as overall cost and long-term outcomes. For persistent back pain, traditional medicine is often more expensive than the nontraditional approaches and, I feel, not as effective. I have seen good results with chiropractic treatment, but, in my opinion, tai chi-based exercise programs may have the best outcomes and may be the most cost effective. When combined with acupuncture, massage and medications, the results can be near miraculous.

Unfortunately, insurance companies are slow to cover the costs of many nontraditional therapies, which are not inexpensive. Fortunately, for those without insurance or who have financial hardship, free acupuncture and massages may be available at some clinics.

Even with good medical evidence, traditional medicine has been slow to integrate many of the effective therapies found in nontraditional medicine. Patients, however, want the best of all therapies, regardless of their origins, and are integrating traditional and nontraditional approaches and benefiting from them.

• Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Hospital Network.