Theories of Mechanism of Action for CAM Pain Management Interventions

Many CAM modalities cannot be explained within the allopathic, physiologic model of causation. Possible explanations of mechanisms of action favored by practitioners are listed below for CAM interventions commonly used in pain management. Although expectancy and placebo factors undoubtedly contribute to all techniques, CAM and allopathic, subtle energy factors are often invoked to explain those techniques that have demonstrated effects in placebo-controlled or sham-controlled studies, for example for therapeutic touch (TT), acupuncture and homeopathy.

Biofeedback

When previously unconscious information is made available to the cortex, new neural connections to the autonomic nervous system can lead to the development of new learned response patterns (neural plasticity). Alternatively, increased relaxation and lowered sympathetic arousal lessens the perception of pain.

Hypnosis

General relaxation in an alpha state renders the mind less distractible and more receptive to therapeutic suggestions.

Meditation

A reversal of the fight-or-flight response, the so-called “relaxation response”, can restore autonomic stability and decrease pain perception.

Craniosacral Therapy (CST)

Enhanced flow of cerebro-spinal fluid via facilitation of an endogenous rhythmic expansion and contraction of the cranial vault within the dural container helps to balance the central nervous system.

Reiki/Therapeutic Touch

Balancing of the subtle energy field; possible electromagnetic correlations have been detected using experimental measurement devices. This model is not yet widely accepted in medical circles.

Acupuncture

Balance of subtle energy flow in the meridians; acupuncture anesthesia involves release of endorphins and regulation of neurotransmitter balance.

Homeopathy

Since no actual molecules of the active ingredient are present after extreme dilution, theories involving “energetic imprints” and specific bio-informational configurations have been invoked.