Postoperative Pain

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Cannabis (Marijuana, weed, hemp) [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (Evidence shows that smoking or ingesting cannabis may help in relieving symptoms of pain, although some studies have yielded mixed results)

Grade of Evidence: low quality of evidence

Red Pepper (Capsaicin):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: weakly in favor (Studies have shown that red peppers have pain relieving effects among some women who have undergone mastectomies for breast cancer)

Grade of Evidence: low quality of evidence

Black Cohosh (cimicifuga Racemosa):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (Available evidence does not support claims that Black Cohosh helps to treat symptoms of postop pain in any way. Studies have yielded mixed results)

Grade of Evidence: moderate quality of evidence

Transcutaneous Electrical Neuromuscular Stimulation:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is not enough evidence supporting the role of TENS in chronic pain therapy)

Grade of Evidence: low quality of evidence

Low-Level Laser Therapy:

Recommendation: no recommendation (There have been ambiguous results on the few studies done investigating the effect of laser therapy on chronic pain)

Grade of Evidence: very low quality of evidence

Acupuncture:

Recommendation: weakly in favor (There is some evidence that suggest that Acupuncture may decrease the need for pain medication)

Grade of Evidence: low quality of evidence

Humor Therapy:

Recommendation: weakly in favor (One study has shown that humor therapy may help increase pain tolerance)

Grade of Evidence: very low quality of evidence

Hypnosis:

Recommendation: weakly in favor (There are many reports that demonstrate that hypnosis helps patients better manage and reduce pain)

Grade of Evidence: low quality of evidence

Image Therapy:

Recommendation: weakly in favor (a review of a number of studies conducted showd that Image Therapy may be helpful in reducing pain)

Grade of Evidence: low quality of evidence

Meditation:

Recommendation: weakly in favor (clinical trials have shown that meditation can help reduce chronic pain)

Grade of Evidence: low quality of evidence

Music Therapy:

Recommendation: weakly in favor (Music therapy has been shown to be effective for short-term management of pain)

Grade of Evidence: low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.nlm.nih.gov/medlineplus/marijuana.html

3. http://nccam.nih.gov/research/extramural/awards/2004/

4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/marijuana

5. http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/treatments/complementary--alternative-medicine/marijuana/index.aspx

6. http://www.ncbi.nlm.nih.gov/pubmed/16957511

7. http://www.ncbi.nlm.nih.gov/pubmed/12965981

8. http://www.ncbi.nlm.nih.gov/pubmed/17589370

9. http://mct.aacrjournals.org/content/6/11/2921.long

10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562334/?tool=pmcentrez