Herbal medicine for low back pain.

BACKGROUND: Low-back pain is a common condition and a substantial economic burden in industrialized societies. A large proportion of patients with chronic low-back pain use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines have been purported for use in low-back pain. OBJECTIVES: To determine the effectiveness of herbal medicine for non-specific low-back pain. SEARCH STRATEGY: We searched the following electronic databases: Cochrane Complementary Medicine Field Trials Register (Issue 3, 2005), MEDLINE (1966 to July 2005), EMBASE (1980 to July 2005); checked reference lists in review articles, guidelines and retrieved trials; and personally contacted individuals with expertise in this very specialized area. SELECTION CRITERIA: We included randomized controlled trials, examining adults (over 18 years of age) suffering from acute, sub-acute or chronic non-specific low-back pain. The interventions were herbal medicines, defined as plants that are used for medicinal purposes in any form. Primary outcome measures were pain and function. DATA COLLECTION AND ANALYSIS: Two authors (JJG & MVT) conducted the database searches. One author contacted content experts and acquired relevant citations. Full references and abstracts of the identified studies were downloaded. A hard copy was retrieved for final inclusion decisions. Methodological quality and clinical relevance were assessed separately by two individuals. Disagreements were resolved by consensus. MAIN RESULTS: Ten trials were included in this review. Two high quality trials examining the effects of Harpagophytum Procumbens (Devil's Claw) found strong evidence that daily doses standardized to 50 mg or 100 mg harpagoside were better than placebo for short-term improvements in pain and rescue medication. Another high quality trial demonstrated relative equivalence to 12.5 mg per day of rofecoxib (Vioxx). Two trials examining the effects of Salix Alba (White Willow Bark) found moderate evidence that daily doses standardized to 120 mg or 240 mg salicin were better than placebo for short-term improvements in pain and rescue medication. An additional trial demonstrated relative equivalence to 12.5 mg per day of rofecoxib. Three low quality trials on Capsicum Frutescens (Cayenne), examining various topical preparations, found moderate evidence that Capsicum Frutescens produced more favourable results than placebo and one trial found equivalence to a homeopathic ointment. AUTHORS' CONCLUSIONS: Harpagophytum Procumbens, Salix Alba and Capsicum Frutescens seem to reduce pain more than placebo. Additional trials testing these herbal medicines against standard treatments are needed. The quality of reporting in these trials was generally poor. Trialists should refer to the CONSORT statement extension for reporting trials of herbal medicine interventions.

The therapeutic potential of melatonin in migraines and other headache types.

A large number of individuals suffer from migraine headaches. Several theories attempt to explain migraine etiology. One such theory holds that since environmental stimuli are well known to trigger migraine headaches, the pineal gland may be involved in migraine etiology. Specifically, a pineal gland irregularity may be the physical origin of migraine headaches, with subsequent physiological changes being secondary. Research has found the pineal hormone melatonin is low in migraine patients. Additionally, several studies found administering melatonin to migraine sufferers relieved pain and decreased headache recurrence in some cases. It has been suggested melatonin may play an important therapeutic role in the treatment of migraines and other types of headaches, particularly those related to delayed sleep phase syndrome. Current research supports the hypothesis that migraines are a response to a pineal circadian irregularity in which the administration of melatonin normalizes this circadian cycle; i.e., melatonin may play a role in resynchronizing biological rhythms to lifestyle and subsequently relieve migraines and other forms of headaches. In addition, research testing the administration of melatonin found it safe in migraine sufferers, with few or no side effects. However, a larger, randomized control trial is needed to definitively determine if administration of melatonin to migraine patients is effective.

The Self-Expansiveness Level Form: examination of its validity and relation to the Neo Personality Inventory--Revised.

This study examined the validity of the Self-expansiveness Level Form of Friedman with particular emphasis on the Transpersonal subscale, a measure of transpersonal self-concept, in terms of its basic psychometric properties and its relation to the NEO Personality Inventory--Revised. Support for the basic psychometric properties of the scale in terms of reliability, factorial validity, and concurrent validity was obtained; however, support was limited for convergent validity as correlations between scores on the Transpersonal subscale and measures of theoretically related constructs were low. Correlational analyses involving the Self-expansiveness Level Form and NEO Personality Inventory--Revised indicated that Transpersonal scores were not appreciably associated with the NEO Personality Inventory--Revised domains. Moreover, factor analysis of NEO Personality Inventory--Revised facets and Self-expansiveness Level Form items generated a solution in which the two measures contributed to separate factors. Discussion of the implications and limitations of the findings is included.