Alternative Arthritis Therapi... Video Transcript
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Alternative Arthritis Therapies: Chiropractic and Massage
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 play videoTime: 04:40 minutes |
Participants
Allan Gibofsky MD, JD, David R. Marks MD, Ifeoma Okoronkwo MD, Stephen Smiles MD, Stephen Ritz DO
Summary
Conventional medical treatments for arthritis have come a long way in recent years. But many people suffering from arthritis pain have found additional comfort in so-called "alternative" or "complementary" therapies. How effective are they? And more importantly, how safe? Join our panel of experts as they discuss these therapies, and how they should be used.
Webcast Transcript
DAVID MARKS, MD: Welcome to our webcast. I'm Dr. David Marks. Alternative or complementary medicine has become increasingly popular over the last few years, especially in the treatment of arthritis. What are these alternative therapies, and do they work?
Joining us to answer these questions is Dr. Allan Gibofsky. He is Professor of Medicine and Public Health at Cornell, and a Rheumatologist at the Hospital for Special Surgery. Welcome.
Next to him is Dr. Ifeoma Okoronkwo, or Dr. O., who is Clinical Instructor at NYU School of Medicine and is an attending physician at the Rusk Institute. Thanks for being here.
What are the different types of alternative therapy that we have to deal with?
IFEOMA OKORONKWO, MD: Well, there is really a broad spectrum of therapies and interventions. One could look at it as that there are mechanical interventions and there are non-mechanical interventions. Some of the more common mechanical interventions would be acupuncture, massage therapy, chiropractic. More esoteric ones would be healing touch, Reiki, etc.
Some of the non-mechanical interventions include some of the oral modalities and medicines, such as herbs. Glucosamine is a very common vitamin or supplement. And also magnets.
DAVID MARKS, MD: Glucosamine is very hot these days. What's the glucosamine story?
ALLAN GIBOFSKY, MD: Glucosamine is a substance that is ingested, sometimes by itself and sometimes with another substance called chondroitin. These are substances, which either by themselves or together or as alternative forms, may be present in cartilage or other structures of the body. The theory is that ingestion of these substances somehow gets to the site of damage and helps repair it.
There is also a well-known phenomenon in medicine called the placebo effect. A certain percentage of the time when you do nothing to a patient but give them a sugar pill, they will respond to it. So I think what we need are very carefully designed studies to demonstrate the efficacy of these substances over a placebo, over a sugar pill, in studies where neither the patient nor the doctor knows what it is that is being given. Until sufficient numbers of what we call double-blind studies are done, one has to treat the anecdotes that we hear with a healthy degree of skepticism. I'm not saying that they don't work, but skeptical as to why they do.
DAVID MARKS, MD: Dr. O., are there any other vitamins or herbs that can be used for arthritis?
IFEOMA OKORONKWO, MD: Allan mentioned chondroitin, which is often combined with glucosamine. But there, again, may be some efficacy to its usage. All of these medicines are not without side effect. So once again, it's important that you integrate your physician into your decision process as to what you choose to use.
Having said that, we as physicians must also remember that up to one third of our patients are using some form of integrative medicine on their own. So it's important for us to ask them what are they using, what are their interests, what are their questions so that we can be part of their decision making process.
ALLAN GIBOFSKY, MD: Absolutely critical. I think our patients are asking us and challenging us to learn as much as we can, not just about what we're comfortable with, but also the kinds of things that we may be a little bit uncomfortable with because we're always uncomfortable when we're not knowledgeable.
DAVID MARKS, MD: But some of these things may work for some people. The story is that we really need to study them further to see really which ones are more effective and which ones aren't.
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