About 126 million adults report having pain in the past three months. Annually, nearly 62 million Americans fill at least one prescription for opioids, and approximately 12 million individuals misuse prescription pain relievers. Alternative and integrative therapies, such as acupuncture, mindfulness (meditation), and Tai Chi, may help some individuals manage pain.
Understanding the effectiveness of these therapies can be a challenge. RAND researchers studied hundreds of reviews of the evidence on the effect of these three therapies on different types of pain.
The chart below compiles information from these studies on the effectiveness of acupuncture, mindfulness, and Tai Chi for the types of pain listed below. Each symbol represents both the likelihood of being effective (for example, color-filled circles represent therapies likely to have a positive effect) and the number of studies on the effect of a particular therapy. Areas of the chart without circles indicate insufficient evaluation of certain combinations of pain type and therapy.
Individuals can use this chart to understand which therapies may be promising to help manage their pain. This chart is not meant to provide medical advice; patients should consult their health care providers before pursuing therapeutic treatment.
Therapies Reviewed
Acupuncture
Mindfulness
Tai Chi
Whole-body pain
Whole-body pain
Therapies
Acupuncture
Mindfulness
Tai Chi
Chronic
20 or more studies with positive effect
20 or more studies with positive effect
No studies
General
Between 10 and 19 studies with potentially positive effect
No studies
Between 10 and 19 studies with potentially positive effect
Fibromyalgia
Between 10 and 19 studies with unclear effect
Less than 10 studies with unclear effect
Less than 10 studies with unclear effect
Cancer
Between 10 and 19 studies with unclear effect
No studies
No studies
Surgical or postoperative
Between 10 and 19 studies with unclear effect
No studies
No studies
Rheumatoid arthritis
Less than 10 studies with unclear effect
No studies
Less than 10 studies with unclear effect
Neuropathic
Less than 10 studies with unclear effect
No studies
No studies
Pain intensity
No studies
Less than 10 studies with unclear effect
No studies
Upper-body pain
Therapies
Acupuncture
Mindfulness
Tai Chi
Headache or migraine
20 or more studies with positive effect
No studies
No studies
Jaw
Less than 10 studies with potentially positive effect
No studies
No studies
Neck
20 or more studies with unclear effect
No studies
No studies
Midsection pain
Therapies
Acupuncture
Mindfulness
Tai Chi
Labor
Between 10 and 19 studies with positive effect
No studies
No studies
Back
20 or more studies with unclear effect
Less than 10 studies with positive effect
No studies
Pregnancy
Less than 10 studies with potentially positive effect
No studies
No studies
Prostatitis
Less than 10 studies with potentially positive effect
No studies
No studies
Menstrual
20 or more studies with unclear effect
No studies
No studies
Carpal tunnel or shoulder
Less than 10 studies with unclear effect
No studies
No studies
Lower-body pain
Therapies
Acupuncture
Mindfulness
Tai Chi
Osteoarthritis
20 or more studies with positive effect
No studies
Less than 10 studies with potentially positive effect
Plantar heel
Less than 10 studies with potentially positive effect
No studies
No studies
Ankle sprain
Between 10 and 19 studies with unclear effect
No studies
No studies
About the Research
This graphic is based on evidence maps for mindfulness (July 2017), Tai Chi (February 2014, updated March 2018), and acupuncture (March 2013, updated March 2018). The evidence maps represent on overview of the evidence found in systematic reviews that identify, extract, synthesize, and appraise information from published research. The methodology is described in detail in the published reports cited below.
Hempel S., and S. Baxi, “Alternative Pain Approaches—Based on 3 Evidence Maps,” Santa Monica, Calif.: RAND Corporation, unpublished researched, 2008, available upon request from Susanne Hempel.
Hempel, S., S. L. Taylor, N. J. Marshall, I. M. Miake-Lye, J. Beroes, R. Shanman, M. R. Solloway, and P.G. Shekelle, Evidence Map of Mindfulness, Washington, D.C.: U.S. Department of Veterans Affairs, VA Evidence-Based Synthesis Program Reports, VA-ESP Project 05-226. October 2014. As of August 9, 2018: https://www.rand.org/pubs/external_publications/EP50729.html
Hempel, S., S. L. Taylor, M. R. Solloway, I. M. Miake-Lye, J. M. Beroes, R. Shanman, M. J. Booth, A. M. Siroka, and P. G. Shekelle, Evidence Map of Acupuncture, Washington, D.C.: U.S. Department of Veterans Affairs, VA Evidence-Based Synthesis Program Reports, VA-ESP Project 05-226, January 2014. As of August 9, 2018: https://www.rand.org/pubs/external_publications/EP50723.html
Hempel, S., S. L. Taylor, M. R. Solloway, I. M. Miake-Lye, J. M. Beroes, R. Shanman, and P. G. Shekelle, Evidence Map of Tai Chi, Washington, D.C.: U.S. Department of Veterans Affairs, VA Evidence-Based Synthesis Program Reports, VA-ESP Project 05-226, September 2014. As of August 9, 2018: https://www.rand.org/pubs/external_publications/EP50728.html
Hilton, L., N. Marshall, A. Motala, S. Taylor, I. M. Miake-Lye, S. Baxi, R. Shanman, M. R. Solloway, J. Beroes, and S. Hempel, “Mindfulness Meditation for Workplace Wellness: An Evidence Map,” WORK: A Journal of Prevention, Assessment and Rehabilitation, in press.
Solloway, M. R., S. L. Taylor, P. Shekelle, I. M. Miake-Lye, J. M. Beroes, R. Shanman, and S. Hempel, “An Evidence Map of the Effect of Tai Chi on Health Outcomes,” Systematic Reviews, Vol. 5, No. 1, 2016. As of August 9, 2018: https://www.rand.org/pubs/external_publications/EP66587.html
Individual References
Vickers, A. J., E. A. Vertosick, G. Lewith, H. MacPherson, N. E. Foster, K. J. Sherman, D. Irnich, C. M. Witt, and K. Linde, Acupuncture Trialists’ Collaboration, “Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis,” Journal of Pain, Vol. 19, No. 5, May 2018, pp. 455–474. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/29198932
Hilton, L., S. Hempel, B. A. Ewing, E. Apaydin, L. Xenakis, S. Newberry, B. Colaiaco, A. R. Maher, R. M. Shanman, M. E. Sorbero, and M.A. Maglione, “Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-Analysis,” Annals of Behavioral Medicine, Vol. 51, No. 2, April 2017, pp. 199–213. As of August 10, 2018: https://www.rand.org/pubs/external_publications/EP66661.htmlBack to table ⤴
Madsen, M. V., P. C. Goetzsche, and A. Hrobjartsson, “Acupuncture Treatment for Pain: Systematic Review of Randomized Clinical Trials with Acupuncture, Placebo Acupuncture, and No Acupuncture Groups,” BMJ, Vol. 338, No. a3115, January 27, 2009. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/19174438
Hall, A., B. Copsey, H. Richmond, J. Thompson, M. Ferreira, J. Latimer, and C. G. Maher, “Effectiveness of Tai Chi for Chronic Musculoskeletal Pain Conditions: Updated Systematic Review and Meta-Analysis,” Physical Therapy, Vol. 97, No. 2, February 1, 2017, pp. 227–238. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/27634919Back to table ⤴
Deare, J. C., Z. Zheng, C. C. Xue, J. P. Liu, J. Shang, S. W. Scott, and G. Littlejohn, “Acupuncture for Treating Fibromyalgia,” Cochrane Database of Systematic Reviews, Vol. 5, May 31, 2013. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/23728665
Theadom, A., M. Cropley, H. E. Smith, V. L. Feigin, and K. McPherson, “Mind and Body Therapy for Fibromyalgia,” Cochrane Database of Systematic Reviews, Vol. 4, April 9, 2015. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/25856658
Mist, S. D., K. A. Firestone, and K. D. Jones, “Complementary and Alternative Exercise for Fibromyalgia: A Meta-Analysis,” Journal of Pain Research, Vol. 6, 2013, pp. 247–260. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/23569397Back to table ⤴
Paley, C. A., M. I. Johnson, O. A. Tashani, and A. M. Bagnall, “Acupuncture for Cancer Pain in Adults,” Cochrane Database of Systematic Reviews, Vol. 10, October 15, 2015. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/26468973Back to table ⤴
Lee, H., and E. Ernst, “Acupuncture Analgesia During Surgery: A Systematic Review,” Pain, Vol. 114, No. 3, April 2005, pp. 511–517. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/15777876
Sun, Y., T. J. Gan, J. W. Dubose, and A. S. Habib, “Acupuncture and Related Techniques for Postoperative Pain: A Systematic Review of Randomized Controlled Trials,” British Journal of Anaesthesia, Vol. 101, No. 2, August 2008, pp. 151–160. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/18522936Back to table ⤴
Wang, C., P. de Pablo, X. Chen, C. Schmid, and T. McAlindon, “Acupuncture for Pain Relief in Patients with Rheumatoid Arthritis: A Systematic Review,” Arthritis and Rheumatism, Vol. 59, No. 9, September 15, 2008, pp. 1249–1256. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/18759255
Han, A., V. Robinson, M. Judd, W. Taixiang, G. Wells, and P. Tugwell, “Tai Chi for Treating Rheumatoid Arthritis,” Cochrane Database of Systematic Reviews, Vol. 3, 2004. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/15266544Back to table ⤴
Ju, Z. Y., K. Wang, H. S. Cui, Y. Yao, S. M. Liu, J. Zhou, T. Y. Chen, and J. Xia, “Acupuncture for Neuropathic Pain in Adults,” Cochrane Database of Systematic Reviews, Vol. 12, December 2, 2017. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/29197180Back to table ⤴
Reiner, K., L. Tibi, and J. D. Lipsitz, “Do Mindfulness-Based Interventions Reduce Pain Intensity? A Critical Review of the Literature,” Pain Medicine, Vol. 14, No. 2, February 2013, pp. 230–242. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/23240921Back to table ⤴
Linde, K., G. Allais, B. Brinkhaus, Y. Fei, M. Mehring, E. A. Vertosick, A. Vickers, and A. R. White, “Acupuncture for the Prevention of Episodic Migraine,” Cochrane Database of Systematic Reviews, Vol. 6, June 28, 2016. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/27351677
Linde, K., G. Allais, B. Brinkhaus, Y. Fei, M. Mehring, B. C. Shin, A. Vickers, and A. R. White, “Acupuncture for the Prevention of Tension-Type Headache,” Cochrane Database of Systematic Reviews, Vol. 4, April 19, 2016. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/27092807Back to table ⤴
Jung, A., B. C. Shin, M. S. Lee, H. Sim, and E. Ernst, “Acupuncture for Treating Temporomandibular Joint Disorders: A Systematic Review and Meta-Analysis of Randomized, Sham-Controlled Trials,” Journal of Dentistry, Vol. 39, No. 5, May 2011, pp. 341–350. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/21354460Back to table ⤴
Trinh, K., N. Graham, D. Irnich, I. D. Cameron, and M. Forget, “Acupuncture for Neck Disorders,” Cochrane Database of Systematic Reviews, Vol. 5, May 4, 2016. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/27145001Back to table ⤴
Smith, C. A., C. T. Collins, C. A. Crowther, and K. M. Levett, “Acupuncture or Acupressure for Pain Management in Labour,” Cochrane Database of Systematic Reviews, Vol. 7, July 6, 2011. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/21735441Back to table ⤴
Furlan, A. D., F. Yazki, A. Tsertsvadze, A. Gross, M. Van Tulder, L. Santaguida, J. Gagnier, C. Ammendolia, T. Dryden, S. Doucette, B. Skidmore, R. Daniel, T. Ostermann, and S. Tsouros, “A Systematic Review and Meta-Analysis of Efficacy, Cost-Effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low-Back Pain,” Evidence-Based Complementary and Alternative Medicine, 2012. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/22203884
Chou, R., R. Deyo, J. Friedly, A. Skelly, R. Hashimoto, M. Weimer, R. Fu, T. Dana, P. Kraegel, J. Griffin, S. Grusing, and E. D. Brodt, “Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline,” Annals of Internal Medicine, Vol. 166, No. 7, April 4, 2017, pp. 493–505. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/28192793Back to table ⤴
Ee, C. C., E. Manheimer, M. V. Pirotta, and A. R. White, “Acupuncture for Pelvic and Back Pain in Pregnancy: A Systematic Review,” American Journal of Obstetrics and Gynecology, Vol. 198, No. 3, March 2008, pp. 254–259. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/18313444Back to table ⤴
Posadzki, P., J. Zhang, M. S. Lee, and E. Ernst, “Acupuncture for Chronic Nonbacterial Prostatitis/Chronic Pelvic Pain Syndrome: A Systematic Review,” Journal of Andrology, Vol. 33, No. 1, January–February 2012, pp. 15–21. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/21436307Back to table ⤴
Smith, C. A., M. Armour, X. Zhu, X. Li, Z. Y. Lu, and J. Song, “Acupuncture for Dysmenorrhoea,” Cochrane Database of Systematic Reviews, Vol. 4, April 18, 2016. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/27087494Back to table ⤴
Sim, H., B. C. Shin, M. S. Lee, A. Jung, H. Lee, and E. Ernst, “Acupuncture for Carpal Tunnel Syndrome: A Systematic Review of Randomized Controlled Trials,” Journal of Pain, Vol. 12, No. 3, March 2011, pp. 307–314. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/21093382
Corbett, M. S., S. J. Rice, V. Madurasinghe, R. Slack, D. A. Fayter, M. Harden, A. J. Sutton, H. Macpherson, and N. F. Woolacott, “Acupuncture and Other Physical Treatments for the Relief of Pain Due to Osteoarthritic of the Knee: Network Meta-Analysis,” Osteoarthritis and Cartilage, Vol. 21, No. 9, September 2013, pp. 1290–1298. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/23973143
Escalante, Y., J. M. Saavedra, A. Garcia-Hermoso, A. J. Silva, and T. M. Barbosa, “Physical Exercise and Reduction of Pain in Adults with Lower Limb Osteoarthritis: A Systematic Review,” Journal of Back and Musculoskeletal Rehabilitation, Vol. 23, No. 4, 2010, pp. 175–186. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/21079296Back to table ⤴
Clark, R. J., and M. Tighe, “The Effectiveness of Acupuncture for Plantar Heel Pain: A Systematic Review,” Acupuncture in Medicine, Vol. 30, No. 4, December 2012, pp. 298–306. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/23099290Back to table ⤴
Kim, T. H., M. S. Lee, K. H. Kim, J. W. Kang, T. Y. Choi, and E. Ernst, “Acupuncture for Treating Acute Ankle Sprains in Adults,” Cochrane Database of Systematic Reviews, Vol. 6, June 23, 2014. As of August 10, 2018: https://www.ncbi.nlm.nih.gov/pubmed/24953665Back to table ⤴
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Managing Pain with Alternative Therapies. Santa Monica, CA: RAND Corporation, 2018. https://www.rand.org/pubs/infographics/IG142.html.
Managing Pain with Alternative Therapies, RAND Corporation, IG-142, 2018. As of May 30, 2023: https://www.rand.org/pubs/infographics/IG142.html