Complementary medicine for axial spondyloarthritis: Is there any scientific evidence?

Abhijeet Danve, Atulya (Atul) Deodhar

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Purpose of review Majority of patients with axial spondyloarthritis (axSpA) report use of complementary and alternative medicine (CAM) therapies before and even after the diagnosis, due to perceived efficacy and wide-spread belief that these modalities lack side effects. In this review, we describe the available scientific evidence for the CAM therapies in axSpA. Recent findings Clinical trials of the CAM therapies in axSpA are generally hampered by small sample size, short duration, difficulties in blinding, lack of control groups and strong placebo effect. Nonetheless, exercise programs like Pilates and mind-body techniques such as Tai Chi may have favorable effect on the disease activity and function. Although not yet confirmed, the modulation of the microbiome with the help of probiotics or fecal transplant has face validity given the evolving scientific rationale. Diet has only limited role in the management of axSpA. Deep tissue massage, omega-3 fatty acids and Stanger bath were found to be useful in small studies. CAM therapies are not always entirely well tolerated, particularly the manipulative techniques like chiropractic and Tui-na in patients with advanced disease and osteoporosis. There are no trials of yoga in axSpA despite the wider acceptance and use of yoga as an effective mind-body technique. Summary Larger and better quality clinical trials of CAM therapies are needed to confirm their efficacy and safety in the management of axSpA and to include them in the 'mainstream' medicine.

Original languageEnglish (US)
Pages (from-to)310-318
Number of pages9
JournalCurrent Opinion in Rheumatology
Volume30
Issue number4
DOIs
Publication statusPublished - Jul 1 2018

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Keywords

  • alternative medicine
  • Ankylosing spondylitis
  • Axial spondyloarthritis
  • Complementary and alternative medicine
  • complementary medicine
  • integrative medicine

ASJC Scopus subject areas

  • Rheumatology

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