Are there any complementary or alternative therapies that are effective for osteoporosis or osteopenia? Can I have a massage, or will that hurt my bones?

Complementary therapies[1] are therapies that are used in addition to conventional (sometimes called "Western") medical treatments or interventions. Alternative therapies[2] are therapies that are used in place of conventional medical treatments. The use of these therapies has increased dramatically over the years. In fact, a recent study of Americans found that when prayer is

included as a complementary and alternative medicine (CAM) therapy, 62% of Americans used CAM therapies in the preceding 12 months. But large clinical studies that compare a CAM therapy with a placebo or with a conventional treatment have rarely been funded, so making a case in support of using CAM therapies to prevent or treat osteoporosis is difficult.

The National Center for Complementary and Alternative Medicine (NCCAM), a division of the National Institutes of Health, divides CAM into the following categories:

• Alternative medical systems such as acupuncture and naturopathic medicine

• Mind-body interventions such as prayer and guided imagery

• Biologically based therapies such as dietary supplements and phytoestrogens

• Manipulative therapies such as acupressure and massage

• Energy-based therapies such as magnet therapy and therapeutic touch

Practitioners of chiropractic, the CAM practice that involves manipulating and aligning bones and surrounding tissues correctly, are educated about ways to modify manipulation techniques to avoid fractures of weak bones. Some chiropractors do not manipulate or align any bones in patients with osteoporosis. They may prefer instead to play a teaching role in counseling patients about appropriate calcium and vitamin D intake, healthy diet, and particularly how to avoid fracturing their bones when exercising. They may also help patients to learn appropriate strengthening exercises, targeting specific muscles.

In some studies of acupuncture, results have been mixed. For the treatment of osteoporosis, acupuncture is more commonly used with herbs in the practice of traditional Chinese medicine (TCM). According to TCM, the kidneys govern the bones, so TCM therapies target strengthening the kidney. Herbs that may be used to treat or prevent osteoporosis include those that boost estrogen levels, such as black cohosh, cypress, sage, ginseng, and licorice, and those that enhance mineral use by the body, such as horsetail, stinging nettie, and knotweed. Before using herbs to prevent or treat osteoporosis, you should consult your clinician and a licensed herbalist. Many of these herbs can interact or interfere with your existing medications.

While not all of the CAM therapies would be appropriate for the management or prevention of osteoporosis, some therapies may help in the management of pain from fractures. For example, hypnotherapy and guided imagery might be helpful. When pain causes stress, there are a number of CAM therapies that would be appropriate for stress management, including massage, aromatherapy, mindfulness, and yoga, to name a few (see Question 82).

Massage is gaining popularity not only because it is relaxing, but because many in the massage field believe that human touch can help all conditions. Massage has been shown to improve pain levels, particularly in people with arthritis, cancer, and low back pain. Most practitioners of massage will take a history from you, and you should be sure to mention that you have osteoporosis if you're not asked specifically. If you are having a chair massage, it is important to refrain from bending your spine forward, as this potentially may cause compression fractures of your spine.

Massages while you're lying down are definitely appropriate and can be beneficial to your stress level. Because it can ease the pain associated with many conditions, massage is a useful adjunct to self-healing. Some believe that massage can help to increase bone mass, at least indirectly, because it can relieve pain, which in turn can make exercise more manageable, and because it can help muscles become more flexible, making exercise more effective for bone health. If they are made aware of any vertebral fractures, massage therapists will be careful to avoid directly manipulating the tissue near the bones in the back. Massage increases blood flow to all areas of the body, improving your circulation, which can boost healing and reduce pain.

  • [1] Therapies that are used in addition to conventional, Western medical treatments or interventions.
  • [2] Therapies that are used in place of conventional Western medical therapies; includes massage, visualization, naturopathic medicine, and acupuncture, among others.
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