An Old Twist on Health
Age-old alternative medicine treatments are showing promise and growing in use to help people with SCI.
When it comes to managing some of the pain and other health issues associated with spinal-cord injuries (SCI), the most effective treatments may not involve the newest drugs but therapies that are hundreds of years old or older.
Complementary and Alternative Medicine (CAM) has taken center stage over the past several years in regulating pain management and stress, as well as increasing overall well-being in people with SCI. CAM is defined as a group of medical, healthcare, and healing systems other than those included in mainstream (Western) medicine.
Its major domains include: alternative healthcare systems (i.e., chiropractic and acupuncture), mind-body interventions (i.e., meditation, hypnosis, guided imagery, and music therapy), biological-based therapies (i.e., herbal therapies), therapeutic massage, energy therapies, and bioeletromagnetics.
The National Center for Complementary and Alternative Medicine estimates nearly 40% of Americans use some form of these treatments. The Department of Veterans Affairs (VA) has been treading carefully on its provisions and funding of CAM.
In 2011, at least 89% of VA medical centers offered alternative forms of therapy, including yoga classes, acupuncture, tai-chi, and meditation. Last year, VA researchers in San Diego received funding to conduct additional studies on CAM’s effectiveness.
Although some patients reported these therapies have allowed them to rely less on pain and sleep medication, the evidence that these therapies provide significant benefits is scant. The absence of significant findings often deals with the difficulty in studying CAM.
CAM Isn’t Easy to Study
A primary research challenge is the tendency of CAM practices to individualize for the patient and not the disease. This leads to varied treatments for people with the same conventional diagnosis.
Additionally, translating a type of CAM from clinical practice to research often results in excessive streamlining of a complex healing system. As a result, most research has examined one modality at a time, which is atypical in real-world CAM therapies.
Chandra Hinton Leichtle
However, the difficulties in studying CAM have not functioned as an absolute barrier to its proposed funding. This April, a bill (S. 852) endorsed by Paralyzed Veterans of America was introduced in the Senate, which expanded more funding for VA study of CAM.
The bill calls for research and education in CAM to develop specific models to be used by VA. Experts have also suggested looking beyond randomized clinical trials to steer evidence for future research, such as investigating certain biomarkers as evidence for effectiveness.
Colorado Medicaid Program
When it comes to increasing CAM funding for people with SCI on Medicaid, the Chandra Plan Foundation is leading this effort in Colorado.
Founded by Chandra Hinton Leichtle, who sustained an SCI when she was 9, the organization looks to help people with disabilities heal their whole bodies. Participants receive education and access to CAM therapies such as acupuncture, massage, chiropractic care, and adaptive yoga.
The foundation recently received funding from the State of Colorado to create a three-year pilot program to study the cost-effectiveness of CAM on health outcomes in the SCI population.
The program, also known as the SCI Waiver, marks the first time to date that Medicaid is funding alternative therapies in Colorado. There are 48 individuals with SCI and on Medicaid now enrolled in the SCI Waiver. They’re participating in acupuncture, massage, chiropractic care, and adaptive yoga.
The results of the program, which includes an independent evaluation, will be reported to the Colorado General Assembly in August 2015.
Bodies Need Movement
Many individuals with SCI speak highly of CAM treatments as a benefit to their health and well-being.
Leichtle includes two acupuncture sessions, two restorative massage sessions, and two chiropractic sessions into her own monthly regimen of care. She also practices adaptive yoga whenever she can squeeze it into her busy schedule.
Her enthusiasm for CAM began eight years ago with her first acupuncture class, which resulted in being pain-free for three years. Her mantra is, “Bodies need movement because movement is life.” And through these various CAM treatments, she is substituting integrative therapy for the things her body can no long do for itself.
Many different products and treatments could fall under the CAM banner, but this is a brief look at some of the most common ones being used.
Adaptive & Restorative Yoga
Adaptive yoga is the practice of adjusting traditional yoga poses for people with SCI and other disabilities.
Use of props and modifications are common in traditional forms of yoga practice, resulting in highly individualized sessions. The same is true for individuals following adaptive yoga. The differences arise in the variety of props used and amount of teachers present.
Props such as tables and blankets are commonly used, and generally three to four yoga teachers are present to continually adjust adaptive yogis during their lesson. The goal is to help individuals with SCI connect with the parts of their bodies that are paralyzed. SCI individuals are attracted to adaptive yoga because it makes them feel grounded and energized, a feeling that is not felt often due to entire days spent sitting in a wheelchair.
In contrast, restorative yoga poses don’t require individuals to do physical work. Restorative yoga students are placed into specific relaxing poses using large bolsters, pillows or blankets. Deep healing to the nervous system is said to occur in these poses.
About nine out of ten VA facilities offer some form of CAM; the most common type is meditation.
Meditation is one form of CAM widely used throughout VA by those with and without SCI. One such meditation technique is mantram (or mantra). It’s the practice of silently focusing on a spiritual word or phrase frequently throughout the day.
A six-week study of 146 veterans performed by Jill Bormann, PhD, RN, at the San Diego VA Healthcare System found that mantram resulted in improvements in “existential spiritual well-being” and confidence in managing posttraumatic stress disorder (PTSD) symptoms.
One main benefit of mantram, as opposed to other relaxation techniques, is that it can be used discreetly, anywhere and anytime.
Acupuncture & Energy
Among other CAM treatments that have become more common, acupuncture and energy therapy are offered at the Milwaukee VA Medical Center.
Acupuncture used in Milwaukee involves auricular and traditional needling and has been successful for a majority of patients in managing pain and increasing overall well-being.
Under traditional Chinese medical theory, traumatic paraplegia is the result of damages in certain meridians, or energy channels, that are permeated by a life force call qi (chee). The aim of acupuncture is to clear and activate meridians, reversing qi stagnation.
Energy therapies use healing touch interventions to facilitate the flow of energy through the body. They target the mind, body, emotion and spirit.
Stan Rintelmann, NP, who has been practicing energy therapies since 1986, heads the Milwaukee VA Energy Therapies clinic. It’s a floating clinic that has been active for three years. The clinic sees roughly three to five patients per week, and patients are encouraged to attend one session every two to three weeks.
Rintelmann says patients typically seek out the clinic for pain management and secondarily for anxiety and stress management. Recently the Milwaukee VA Medical Center received federal funding to research the benefits of energy therapies to health outcome and educate other practitioners to expand these therapies to other veterans.
For more information on complementary and alternative medicine, consult your doctor or visit healingtherapies.info.
An Old Twist on Health
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