There isn’t much scientific proof that complementary and alternative medicine (CAM) – from aromatherapy to reflexology – helps with the pain and disability associated with rheumatoid arthritis (RA), osteoarthritis (OA), fibromyalgia and low back pain. But based on the available evidence, researchers in the United Kingdom, who evaluated clinical studies on 21 CAM therapies for the four conditions, concluded that acupuncture, massage, yoga and tai chi work in some cases.

These findings don’t mean that other CAM therapies – defined by this report as any therapy that exists outside normal health care practices – aren’t effective. The researchers stress that, in many cases, there just weren’t enough high-quality data to fully evaluate the therapies. “Where there is no or little evidence, it is very difficult to judge,” says lead author of the report, Gareth Jones, PhD, a senior lecturer in epidemiology in the School of Medicine and Dentistry at the University of Aberdeen in Scotland.

The report is one of two published recently by Arthritis Research UK, a large medical-research organization. The other report rated supplements in the treatment of OA, RA and fibromyalgia.

To evaluate CAM treatments, the researchers used a five-point scale to judge the effectiveness of each. A ranking of 1 indicates little to no evidence of efficacy; 5 means there is consistent evidence from high-quality trials that a therapy improved patients’ pain, disability and quality of life.

Researchers also rated treatments’ safety profiles, using green for safe, red for unsafe and amber for somewhere in between.

Overall, acupuncture got high marks for helping in OA, low back pain and fibromyalgia. Massage was deemed effective for fibromyalgia and low back pain. Tai chi helped OA, and yoga was effective for low back pain.

Other CAM therapies that were evaluated – but came up short – included aromatherapy, autogenic training, biofeedback, copper bracelets, craniosacral therapy, healing therapies, hypnotherapy, imagery, magnet therapy, meditation, music therapy, qigong and reflexology.

Here are more details on the findings.

Rheumatoid Arthritis

A review of 24 trials testing nine therapies on slightly more than 1,500 patients found no treatment worked or had enough evidence to support efficacy among those with RA. The highest scores given in this category were a 2 on the 5-point scale – indicating a little evidence – for biofeedback, relaxation therapy and tai chi.

Daniel J. Clauw, MD, a professor of medicine in the division of rheumatology at the University of Michigan in Ann Arbor, says the message to RA patients is: Don’t use CAM therapies instead of conventional treatments, because there are very effective medications on the market to treat RA pain and aggressively address damage to joints. “You could be doing more than wasting time and money while dabbling with CAM therapies if you aren’t also making sure the inflammation is being well controlled,” Dr. Clauw says.