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Alternative Medicine for Pain in Parkinson's Disease

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Updated April 17, 2009

Geraniums.

Researchers are beginning to look into the beneifts of natural remedies, like geranium oil, to relieve central pain.

Steve Woods/HAAP Media

Pain associated with Parkinson's disease has two primary causes: the muscle aches and pains that are due to motor problems of PD, and pain from changes in the brain itself, also known as central pain. First, make sure you discuss the best dosing of your PD medications so rigidity is reduced. Second, try to increase physical exercise or seek out physical therapy. If you have not taken advantage of physical therapy programs or exercise classes, you may wish to speak to your doctor about this as a route to reduce your pain symptoms.

If you have central pain, well, you know that exercise, or medication adjustments is probably not enough. Other therapies are necessary as well.

To date, there are only a few therapies available for central pain syndromes of PD. None of them appear to work for everyone. That is why some persons with PD turn to the so-called complementary and alternative or CAM therapies to find relief from their pain symptoms.

Here is a description of some of those CAM therapies that have demonstrated success in treating central pain disorders in people without PD. They may also work for you.

To my knowledge there has not yet been any studies of CAM therapies for pain in PD so it is unknown whether CAM works for pain control in PD but it may be worth a try as long as your PD physician is aware of your treatments and approves them.

Acupuncture

I have spoken with several persons with PD and read several personal accounts of persons with PD who benefit from acupuncture. Both their motor symptoms and their pain symptoms benefit. Of course personal testimony doesn’t cut it scientifically. Only “randomized clinical trials” of a therapy provide reliable evidence as to the effectiveness of a therapeutic system. In these clinical trials neither the therapist nor the patients knows who is getting the real therapy and the effects of the therapies are measured with objective instruments. With acupuncture therapy sterile needles are inserted into the skin of a patient at certain points on the body defined by traditional Chinese medical practitioners as important "energy" meridians in the body. The idea is that pain comes from an imbalance of energies in the body and the needle insertions can help rebalance energy systems. To date there have been only a handful of clinical trials of acupuncture for central pain syndromes and none of them reported unequivocal evidence of pain reduction.

On the other hand, patients often reported that they generally felt better after treatments. So the jury is still out with respect to acupuncture.

Electrostimulation

During electrostimulation therapy, an electrical pulse is applied to the skin in the area where pain is felt most intensely. For most central pain syndromes this is a problem as the pain is often "general" or "inside" and is not specific to one area of the body. Nevertheless, stimulation on various regions and points in the body has been reported to be helpful for patients with diabetic neuropathy - a form of central pain.

Massage

As far as I kno,w gentle forms of massage has never made anyone feel worse than they felt before the massage. Deeper forms of therapeutic massage have a greater impact on muscles and tissues of the body so be sure to speak to your doctor before getting this kind of massage. Theoretically, massage may help with central pain because it sends patterned and pleasurable impulses up to the brain thereby masking, to some extent, the chaotic and burning central pain impulses. To date, however, no clinical trials have been done on massage therapy for central pain syndromes of PD. In my opinion, every person with PD should make gentle massage with a licensed practitioner a regular practice — as long as your PD doctor has no concerns.

Herbal Medicine

Persons with PD have to be extra careful when taking any new herbs or vitamin supplements as some herbs, like St John’s Wort, may interact dangerously with your PD medications. One herbal treatment for pain that has received some attention is cannabis, otherwise known as marijuana. There has been at least one clinical trial on cannabis and treatment of central pain and that trial was conducted with persons who had multiple sclerosis. The treatment was a whole-plant cannabis-based medicine delivered via an oromucosal spray. Scientists found that cannabis was superior to placebo in reducing mean pain intensity and was generally well tolerated. Another herb that looks promising for treatment of central pain is geranium (Pelargonium spp) oil. Researchers found a dose-dependent pain control effect for this herb in persons with a severe central pain syndrome known as "postherpetic neuropathy."

Dose-dependent means that the greater the dose of the herb the greater the reduction in pain.

Topical capsaicin

Capsacin is a chemical that is normally produced by the body to promote tissue inflammation and healing. When it is prepared in an ointment form you place it on a painful area or a sore to facilitate healing. Topical ointment capsacin has been studied as an adjunctive therapy for some central pain syndromes—that is it is not considered the main therapy for central pain but when used with other stronger therapies like pain control medications it may be helpful for some persons.

Source:

Ernst E, Pittler MH, Wider B, et al. Complementary and Alternative Medicine for Pain. London: Mosby/Elsevier; 2007.

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