Complementary and Integrative Health

Complementary and integrative health (CIH) is a group of medical treatments that are not part of mainstream, or conventional, medicine. Here, mainstream medicine refers to traditional Western medicine practiced by medical doctors.¹

CIH includes a wide range of treatments, which makes it an attractive option for people living with axial spondyloarthritis (axSpA). The challenge lies in discovering how much relief these therapies might bring people suffering from axSpA.^1,2

What is the difference between complementary, alternative, and integrative medicine?

You may have heard the words "complementary," "alternative," or "integrative" to describe this type of holistic therapy. They are sometimes used interchangeably, but they have different meanings.¹

Complementary medicine is often used with mainstream medicine. For example, a person might take herbs along with prescription medicines. Alternative medicine is sometimes used instead of mainstream medicine to treat an illness or symptom. And integrative medicine combines mainstream, complementary, and alternative therapies.¹

How does CIH work?

CIH emphasizes total well-being, not just treating the symptoms of a certain health condition. It is based on the belief that your body can heal itself. Healing involves using different methods that involve your mind, body, and spirit. Specific treatment usually depends on what you are feeling at that time.¹

Examples of CIH treatments

CIH therapies are often grouped by their approach:³

• Body-based therapies
• Alternative medicine
• Biological based therapies (BBT)
• Energy therapies
• Mind-body therapies

Specific CIH therapies for people with axSpA include:⁴

• Acupuncture (alternative medicine approach)
• Bodywork (body-based approach)
• Diet (BBT approach)
• Herbs and supplements (BBT approach)
• Medical marijuana and CBD (BBT approach)
• TENS units (body-based approach)
• Yoga (mind-body approach)

Acupuncture

Acupuncture is a form of traditional Chinese medicine. It involves inserting thin needles into strategic points on the body. This is said to help balance life force energy, called chi or qi. There has not been much research done on the effect of acupuncture on people with axSpA specifically.^1,2,4

Bodywork

Bodywork is when someone touches or moves your body's muscles, joints, or soft tissues. This can help relieve pain and stiffness. It can also help you relax and feel less stress. Bodywork approaches include massage and chiropractic care.^1,4

Diet

People with axSpA may change what they eat to help control their symptoms. No one specific diet has been shown to make axSpA better or worse. But some foods are known to cause inflammation, while others can help reduce it. Some people are also sensitive to certain foods, which may worsen their symptoms.^5,6

Eating a diet rich in fruits and vegetables has been shown to improve overall health. Fruits like bananas can help you get the vitamins and minerals needed for your joints and muscles. Talk to your doctor before beginning a specific diet. They can help you decide which foods you might want to introduce or cut out.^5,6

Herbs and supplements

Some people with axSpA use vitamins, minerals, and herbal supplements to help manage their symptoms or improve their overall health. Examples of supplements that people with axSpA may take include:^2,7-9

• Omega 3 fatty acids (fish oil)
• Calcium
• Vitamin D
• Folic acid
• White willow bark
• Turmeric
• Boswellia

Talk to your doctor first before taking any of these supplements. Some herbs and supplements can interfere with medicines, making them less effective or causing worse side effects.⁹

Also note that supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency confirms the ingredients or suggested dose. This can be dangerous. Your doctor can help you decide if a supplement is safe.⁷

Medical marijuana and CBD

Marijuana is a type of the Cannabis sativa plant. Cannabis is any form of marijuana used for any reason. Medical marijuana is cannabis a doctor prescribes to help treat certain health conditions.^10,11

The chemical in cannabis that makes people feel “high” is called THC. It also has positive effects for some people, including pain relief. CBD is another chemical in cannabis that has positive effects, such as reducing inflammation and providing pain relief. Medical marijuana usually has more CBD and less THC than recreational marijuana.^10,11

There is a limited amount of research on the effects of medical marijuana or CBD on people with axSpA. But some studies look promising and suggest that there could be benefits. CBD may help with pain relief, especially for people with chronic low back pain, neck pain, and knee pain from wear and tear. CBD may also help reduce symptoms such as feeling tired and anxious.¹²

TENS units

A transcutaneous electrical nerve stimulation (TENS) unit is a small, battery-powered machine that sends electrical pulses through the skin. These pulses block pain signals from reaching the brain. The machine works through electrodes that are placed on the skin in areas where there is pain.¹³

Yoga

Yoga is an exercise that combines stretching and strengthening the body, breathing, and meditation. Yoga can help people with axSpA manage their symptoms.^2,14

There have not been many studies about the effect of yoga on people with axSpA specifically, but there have been some studies about yoga and general back pain. These studies showed that people who do yoga regularly for 6 months may have less disability, pain, and depression.^2,14

Other things to know

These are not all the CIH options available. Talk to your doctor about how this approach might help you manage your axSpA symptoms.

Unfortunately, there is not much research on the effects of CIH therapies on people with axSpA. This makes it hard for doctors to know whether to recommend these treatments. More research is needed to know whether CIH truly benefits those with axSpA.²