What’s the Bottom Line?

How much do we know about the effectiveness of complementary health approaches for chronic pain?

• A growing body of evidence suggests that some complementary approaches, such as acupuncture, hypnosis, massage, mindfulness meditation, music-based interventions, spinal manipulation, tai chi, qigong, and yoga, may help to manage some painful conditions.

What do we know about the safety of complementary health approaches for chronic pain?

• Although the psychological and/or physical approaches (e.g., acupuncture, meditation, yoga, massage) studied for chronic pain have good safety records, that doesn’t mean that they’re risk-free for everyone. Your health and special circumstances (such as pregnancy) may affect the safety of these approaches. If you’re considering nutritional approaches such as dietary supplements, remember that natural doesn’t always mean safe and that some dietary supplements may have side effects or interact with medications.

What Is Chronic Pain and Why Is It Important?

Chronic pain is pain that lasts more than several months (variously defined as 3 to 6 months, but longer than “normal healing”). It’s a very common problem. Results from the 2019 National Health Interview Survey (NHIS) show that:

• About 20.4 percent of U.S adults had chronic pain (defined as pain on most days or every day in the past 3 months).
• About 7.4 percent of U.S. adults had high-impact chronic pain (defined as chronic pain that limited their life or work activities on most days or every day for the past 3 months).

Chronic pain becomes more common as people grow older, at least in part because some health problems that can cause pain, such as osteoarthritis, become more common with advancing age. Military veterans are another group at increased risk for chronic pain; U.S. national survey data show that both pain in general and severe pain are more common among veterans than nonveterans. Chronic pain is more common in rural areas than urban areas in the United States.

Analysis of data from the 2010–2017 NHIS Sample Adult Core and Adult Functioning and Disability Supplement show that prevalence of chronic pain varies by race and Hispanic origin, with a recent publication suggesting the highest percentage among non-Hispanic American Indian/Alaska Native respondents and the lowest among non-Hispanic Asians. 

Not all people with chronic pain have a health problem diagnosed by a health care provider, but among those who do, the most frequent conditions are low-back pain or osteoarthritis, according to a national survey. Other common diagnoses include rheumatoid arthritis, migraine, carpal tunnel syndrome, and fibromyalgia.

Chronic pain may result from an underlying disease or health condition, an injury, medical treatment (such as surgery), inflammation, or a problem in the nervous system (in which case it is called “neuropathic pain”); or the cause may be unknown. Pain can affect quality of life and productivity, and it may be accompanied by difficulty in moving around, disturbed sleep, anxiety, depression, and other problems.¹

¹Certain chronic conditions, several of which cause pain, may occur together; some individuals have two or more of these problems. These conditions include chronic fatigue syndrome, endometriosis, fibromyalgia, interstitial cystitis (painful bladder syndrome), irritable bowel syndrome, temporomandibular joint dysfunction, and vulvodynia (chronic vulvar pain). It is not known whether these disorders share a common cause.

What the Science Says About Complementary Health Approaches for Chronic Pain

The scientific evidence suggests that some complementary health approaches may help people manage chronic pain. 

A comprehensive description of scientific research on all the complementary approaches that have been studied for chronic pain is beyond the scope of this fact sheet. This section highlights the research status of some approaches used for common kinds of pain.

Chronic Pain in General

Some recent research has looked at the effects of complementary approaches on chronic pain in general rather than on specific painful conditions. 

• A 2017 review looked at complementary approaches with the opioid crisis in mind, to see which ones might be helpful for relieving chronic pain and reducing the need for opioid therapy to manage pain. There was evidence that acupuncture, yoga, relaxation techniques, tai chi, massage, and osteopathic or spinal manipulation may have some benefit for chronic pain, but only for acupuncture was there evidence that the technique could reduce a patient’s need for opioids.
• Products containing substances from cannabis (marijuana), which typically include both tetrahydrocannabinol (THC) and cannabidiol (CBD), have been tested for their effects on chronic pain in short-term studies. Oral products with high THC/CBD ratios and sublingual (under-the-tongue) products with roughly equal amounts of THC and CBD may reduce chronic pain in the short term but may also have side effects including dizziness and sleepiness. Not much is known about other cannabinoid formulations or the effects of long-term use.
• Hypnosis may reduce chronic pain if patients participate in enough sessions (at least eight), according to a few studies.
• Studies on chronic pain showed that mindfulness-based interventions and cognitive behavioral therapy are both helpful in decreasing pain intensity and improving physical functioning, with no important difference between the two approaches. Cognitive behavioral therapy is the prevailing psychological intervention for chronic pain.
• Studies have shown that music-based interventions can reduce self-reported pain and depression symptoms in people with chronic pain. Effects were greater when the patient, rather than the researcher, chose the music.

Back and Neck Pain

• A large review of individual data from multiple studies showed that acupuncture was more effective than either no treatment or sham (fake) acupuncture for back or neck pain. The difference between acupuncture and no treatment was greater than the difference between acupuncture and sham acupuncture. A 2017 clinical practice guideline (guidance for health care providers) from the American College of Physicians (ACP) included acupuncture among the nondrug treatment options for management of both acute and chronic low-back pain.
• Evaluations of massage therapy for low-back pain have found weak evidence that it may be helpful. The ACP guideline recommends massage as an option for acute low-back pain, based on low-quality evidence, but does not recommend massage for chronic low-back pain. Massage therapy may be helpful for neck pain, but the benefits may only last for a short time.
• Studies show that mindfulness-based stress reduction is associated with a small improvement in chronic low-back pain. The ACP guideline recommends mindfulness-based stress reduction as an option for chronic low-back pain, based on moderate-quality evidence.
• Progressive muscle relaxation is one of several nondrug approaches suggested as the first step in treating chronic low-back pain in the ACP treatment guideline. There is evidence that this technique can lead to moderate improvements in low-back pain and back function.
• Biofeedback may moderately improve low-back pain. It is one of the nondrug approaches suggested as the first step in treating chronic low-back pain in the ACP treatment guideline.
• The 2017 ACP guideline includes spinal manipulation as an option for treating both acute and chronic low-back pain. There is low-to-moderate quality evidence that spinal manipulation can reduce pain and improve function in people with chronic nonspecific neck pain.
• Tai chi, either alone or in addition to physical therapy, may decrease the intensity of pain and improve everyday function in people with low-back pain. The ACP guideline includes tai chi as an option for treatment of chronic low-back pain.
• Studies of yoga for low-back pain have shown yoga to be helpful in both the short term (1 to just under 6 months) and intermediate term (6 to just under 12 months). The effects of yoga are similar to those of other types of exercise. The 2017 ACP guideline included yoga as an option for initial treatment of chronic but not acute low-back pain. Practicing yoga has been shown to reduce both the intensity of neck pain and disability related to neck pain.
• Several types of herbal preparations have been evaluated for low-back pain. There is evidence that topical products containing the herb cayenne, such as creams and plasters, can reduce pain. Topical products that contain two other herbs, comfrey and lavender essential oil, and two herbs used orally, white willow bark and devil’s claw, may also be helpful, but the evidence for these herbs is not as strong as that for cayenne.

Osteoarthritis

• Acupuncture may be helpful for knee pain associated with osteoarthritis. There’s less evidence on whether it’s helpful for osteoarthritis of the hip. The 2019 clinical practice guideline from the American College of Rheumatology and the Arthritis Foundation conditionally (i.e., weakly) recommends the use of acupuncture for arthritis of the hand, hip, or knee but acknowledges that the evidence on acupuncture is controversial and that most of the studies that have shown beneficial effects have been for knee osteoarthritis.
• Low-to-moderate quality evidence suggests that massage may help reduce pain associated with arthritis; most of the research has been on osteoarthritis rather than rheumatoid arthritis. However, the guideline from the American College of Rheumatology and the Arthritis Foundation conditionally (i.e., weakly) recommends against the use of massage therapy for the management of osteoarthritis of the hip or knee because of weaknesses in the scientific evidence.
• In research studies, people with osteoarthritis who practiced tai chi experienced improvements in pain, stiffness, balance, and physical function. The guideline from the American College of Rheumatology and the Arthritis Foundation strongly recommends tai chi for the management of osteoarthritis of the knee or hip.
• A limited amount of research suggests that yoga may be helpful for improving pain, function, and stiffness in people with osteoarthritis of the knee. The guideline from the American College of Rheumatology and the Arthritis Foundation conditionally recommends yoga for patients with knee osteoarthritis based on similarities to tai chi, which has been studied more extensively.
• In their guideline for the management of osteoarthritis of the hand, hip, and knee, the American College of Rheumatology and the Arthritis Foundation strongly recommend against the use of glucosaminefor people with arthritis in any of these three body sites. The rationale is that studies with the lowest risk of bias have not shown glucosamine to work better than a placebo (an inactive substance). The guideline also recommends against the use of chondroitin or combination glucosamine/chondroitin products for osteoarthritis of the hip or knee. It conditionally recommends for the use of chondroitin for hand osteoarthritis, however, based on a single study that showed a pain-relieving effect, as well as chondroitin’s apparent safety.
• The guideline from the American College of Rheumatology and the Arthritis Foundation conditionally recommends against the use of fish oil for osteoarthritis because only one study exists, and that study did not show efficacy of a higher dose of fish oil over a lower dose. The guideline conditionally recommends against the use of vitamin D for osteoarthritis because the overall evidence does not show a benefit.
• There isn’t enough research on dimethyl sulfoxide (DMSO) or methylsulfonylmethane (MSM) for osteoarthritis pain to allow conclusions to be reached. The evidence on S-adenosyl-L-methionine(SAMe) for osteoarthritis of the knee or hip is inconclusive.

Rheumatoid Arthritis

• The term balneotherapy refers to bathing in mineral water for health purposes and related techniques such as mud packs. There’s evidence that balneotherapy may be helpful for improving quality of life in people with rheumatoid arthritis.
• Omega-3 fatty acids of the types found in fish oil may have beneficial effects on rheumatoid arthritis when used in addition to conventional drug therapy.
• No nutritional approach other than omega-3 fatty acids has shown clear benefits for rheumatoid arthritis, but there is preliminary evidence for a few dietary supplements, particularly gamma-linolenic acid (contained in evening primrose oil, borage seed oil, and black current seed oil) and the herb thunder god vine.
• A few small studies have evaluated tai chi in people with rheumatoid arthritis, but it’s uncertain whether this approach is helpful.

Headaches

• There’s moderate-quality evidence that acupuncture may reduce the frequency of migraines and moderate-to-low quality evidence that it may reduce the frequency of tension headaches. Studies that compared acupuncture with various drugs for preventing migraine found that acupuncture was slightly more effective and that study participants who received acupuncture were much less likely than those who received drugs to drop out of studies because of side effects.
• Studies of electromyography (EMG) biofeedback, a type of biofeedback involving measurements of muscle tension, have found this technique helpful for tension headaches.
• Some studies of relaxation techniques for migraines or tension headaches have shown improvements, including a reduction in headache frequency, in people who used the techniques. The evidence is strongest for relaxation techniques used in combination with cognitive behavioral therapy.
• Spinal manipulation may reduce the frequency and intensity of cervicogenic headaches (head pain that originates from a problem in the neck). Preliminary evidence suggests it may also be helpful for migraines.
• A small amount of research suggests that practicing yoga may reduce headache frequency, headache duration, and pain intensity, with beneficial effects seen primarily in tension headaches rather than migraines.
• Several dietary supplements have been studied for migraines. There is some evidence that coenzyme Q10, feverfew, magnesium, and the B vitamin riboflavin might help reduce the frequency of migraines. For all these supplements, the amount of evidence is small. The herb butterbur appears to reduce the frequency of migraines. However, serious concerns have been raised about possible liver toxicity from butterbur.
• The results of a recent study showed that diets high in omega-3 fatty acids may be helpful for migraines. Omega-3 supplements have not been shown to make migraines less frequent or severe, but a small amount of evidence suggests that they might reduce the duration of migraine attacks.

Fibromyalgia

• Low-to-moderate quality evidence suggests that acupuncture is helpful for pain associated with fibromyalgia.
• Several studies show that massage therapy, if continued for 5 weeks or longer, may reduce pain and improve other symptoms in people with fibromyalgia.
• A small amount of research suggests that tai chi can help reduce pain and improve other symptoms in people with fibromyalgia.
• The term balneotherapy refers to bathing in mineral water for health purposes and related techniques such as mud packs. There’s evidence that balneotherapy may be helpful for some symptoms of fibromyalgia.
• The effectiveness of biofeedback, mindfulness, movement therapies, and relaxation-based therapies for fibromyalgia is unclear because the quality of the evidence on these approaches is low.
• Supplementation with vitamin D may reduce fibromyalgia pain, particularly in individuals with vitamin D deficiency.
• There is insufficient evidence that other dietary supplements can relieve fibromyalgia pain. 

Irritable Bowel Syndrome

• The evidence suggests that acupuncture is no more effective than sham acupuncture for irritable bowel syndrome (IBS) symptoms, but it may be helpful when used in addition to other forms of treatment.
• The 2021 American College of Gastroenterology (ACG) guideline for treatment of IBS suggests that gut-directed hypnotherapy or other gut-directed psychotherapies can be used to treat global IBS symptoms in some patients, but the quality of the evidence is very low.
• Probiotics may be helpful for symptoms of IBS, but different strains of probiotics may have different effects. The 2021 ACG guideline suggests that probiotics should not be used for the treatment of IBS symptoms because the current evidence doesn’t clearly show which probiotics might be helpful.
• Studies on peppermint have suggested that it may be helpful for overall symptoms and abdominal pain in people with IBS, and the ACG guideline suggests that it can be used, although the evidence is not strong.

Less-Studied Complementary Approaches

• Research on the plant product kratom is in its early stages, and much more needs to be learned about its effects in the body, its safety, and whether it may have therapeutic uses, including possible use in the treatment of pain.
• Reiki is a complementary health approach in which practitioners place their hands lightly on or just above the person, with the goal of facilitating the person’s own healing response. There isn’t enough high-quality research to evaluate whether Reiki is helpful for relieving pain.
• Magnets. Both static magnets and electromagnets have been studied as treatments for pain. Static magnets have magnetic fields that don’t change. They may be put into products such as wristbands, shoe insoles, bracelets, and bed pads. There’s not much research on static magnets for pain, and there’s no conclusive evidence that they’re helpful for any type of pain. Electromagnets become magnetic when an electrical current charges the metal. Current research suggests that electromagnetic field therapy can relieve pain and improve function in patients with various musculoskeletal pain conditions and some osteoarthritis conditions, although the data are mixed.

What the Science Says About Safety and Side Effects

As with any treatment, it’s important to consider safety before using complementary health approaches. Safety depends on the specific approach and on the health of the person using it. If you’re considering or using a complementary approach for pain, check with your health care providers to make sure it’s safe for you.

Safety of Psychological and Physical Approaches

• Psychological and physical complementary health approaches, such as acupuncture, hypnosis, massage therapy, mindfulness/meditation, music-based interventions, relaxation techniques, spinal manipulation, tai chi, qigong, and yoga, are generally safe for healthy people if they’re performed appropriately.
  • People with medical conditions and people who are pregnant may need to modify or avoid some of these practices.
  • Like other forms of exercise, complementary health practices that involve movement, such as tai chi and yoga, can cause sore muscles and may involve some risk of injury.
  • It’s important for practitioners and teachers of mind and body practices to be properly qualified and to follow appropriate safety precautions.

Safety of Nutritional Approaches

• “Natural” doesn’t always mean “safe.” Some dietary supplements may have side effects and may interact with medications. 
• The U.S. Food and Drug Administration has warned the public about several dietary supplements promoted for arthritis or pain that were tainted with prescription drugs.

Guidelines for the Treatment of Chronic Pain Conditions

National health professional organizations have issued guidelines for treating several chronic pain conditions that address the use of complementary health approaches.

• A clinical practice guideline from the American College of Physicians encourages the use of nonpharmacologic approaches as initial treatment for chronic low-back pain. The options they suggest include several complementary approaches—acupuncture, mindfulness-based stress reduction, tai chi, yoga, progressive relaxation, biofeedback, and spinal manipulation—as well as conventional methods such as exercise and cognitive behavioral therapy.
• The American College of Rheumatology and the Arthritis Foundation have published a guideline for the management of osteoarthritis of the hand, hip, or knee that includes recommendations for or against the use of a variety of complementary health approaches. For example, the guideline strongly recommends for the use of tai chi for osteoarthritis of the hip or knee and strongly recommends against the use of glucosamine for osteoarthritis at any of the three body sites. The guideline’s recommendations are discussed in more detail in the Osteoarthritis section of this fact sheet.
• The American College of Gastroenterology clinical guideline for irritable bowel syndrome includes conditional (weak) recommendations in favor of peppermint and gut-directed psychotherapies (a group of therapies that includes gut-directed hypnotherapy). The guideline includes a conditional recommendation against the use of probiotics. 
• The 2022 Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain concludes: “Evidence exists that multiple noninvasive nonpharmacologic interventions improve chronic pain and function, with small to moderate effects in specific pain conditions, and are not associated with serious harms.” Several of the nonpharmacologic approaches discussed in this fact sheet, such as acupuncture, massage therapy, mindfulness-based interventions, tai chi, and yoga, are mentioned in the CDC practice guideline as being appropriate for some types of chronic pain. The guideline recommends maximizing pain treatment with nonpharmacologic and nonopioid pharmacologic treatments as appropriate. 

If You're Considering Complementary Health Approaches for Chronic Pain

• Don’t use an unproven product or practice to postpone seeing a health care provider about chronic pain or any other health problem.
• Learn about the product or practice you are considering, especially the scientific evidence on its safety and whether it works.
• Talk with the health care providers you see for chronic pain. Tell them about the product or practice you’re considering and ask any questions you may have. They may be able to advise you on its safety, use, and likely effectiveness.
• If you’re considering a practitioner-provided complementary health approach such as spinal manipulation, massage, or acupuncture, ask a trusted source (such as your health care provider or a nearby hospital) to recommend a practitioner. Find out about the training and experience of any practitioner you’re considering. Ask whether the practitioner has experience working with your pain condition.
• If you’re considering dietary supplements, keep in mind that they can cause health problems if not used correctly, and some may interact with prescription or nonprescription medications or other dietary supplements. Your health care provider can advise you. If you’re pregnant or nursing a child, or if you’re considering giving a child a dietary supplement, it’s especially important to consult your (or the child’s) health care provider.

Recent systematic reviews and randomized clinical trials provide encouraging evidence that practices such as tai chi, qi gong, yoga, acupuncture, mindfulness, and biofeedback may help relieve some fibromyalgia symptoms. Current diagnostic criteria are available from the American College of Rheumatology. Treatment often involves an individualized approach that may include both pharmacologic therapies (prescription drugs, analgesics, and NSAIDs) and nonpharmacologic interventions such as exercise, muscle strength training, cognitive-behavioral therapy, movement/body awareness practices, massage, acupuncture, and balneotherapy.

What Does the Research Show?

• In 2017, the European League Against Rheumatism (EULAR) evaluated non-pharmacologic therapies, including complementary health approaches, and issued revised recommendations for the management of fibromyalgia. The strength of these recommendation is “based on the balance between desirable and undesirable effects (considering values and preferences), confidence in the magnitude of effects, and resource use. A strong recommendation implies that, if presented with the evidence, all or almost all informed persons would make the recommendation for or against the therapy, while a weak recommendation would imply that most people would, although a substantial minority would not.”
  • Based on the evaluation of acupuncture, meditative movement practices (e.g., tai chi, qi gong, and yoga), and mindfulness-based stress reduction, the recommendation for each was weak for use of the therapy.
  • Based on the evaluation of biofeedback, hydrotherapy, and massage therapy, the recommendation for each was weak against use of the therapy.
  • Based on the evaluation of chiropractic, the recommendation was strong against use of the therapy.
• A 2018 randomized controlled trial involving 226 adults with fibromyalgia found that high-intensity and frequent tai chi (i.e., 2 times a week) reduced symptom severity at 24 weeks more than supervised aerobic exercise. In addition, the study found that patients are more likely to attend tai chi classes than aerobic exercise sessions.
• A 2015 Cochrane review of 61 trials involving 4,234 predominantly female participants with fibromyalgia concluded that the effectiveness of biofeedback, mindfulness, movement therapies, and relaxation techniques remains unclear as the quality of evidence was low or very low.
• A 2013 Cochrane review of 9 studies involving a total of 395 participants found low-to-moderate evidence that acupuncture improves pain and stiffness in people with fibromyalgia, compared with no treatment and standard therapy. The reviewers also found moderate-level evidence that the effect of acupuncture does not differ from sham acupuncture in reducing pain or fatigue, or improving sleep or global well-being.
• A 2018 Agency for Healthcare Research and Quality (AHRQ) systematic review of noninvasive nonpharmacological treatment of chronic pain concluded that exercise, CBT, Myofascial release massage, tai chi, qigong, acupuncture and multidisciplinary rehabilitation (MDR) improved function and/or pain for at least one month.

Safety

• Acupuncture is considered safe when performed by a qualified and competent practitioner using sterile needles. Few complications have been reported. Serious adverse events related to acupuncture are rare, but include infections and punctured organs.
• Tai chi is a relatively safe practice; however, some patients should modify or avoid certain tai chi postures due to acute back pain, knee problems, bone fractures, sprains, and osteoporosis.

Results of research on mind and body practices such as relaxation training, biofeedback, acupuncture, and spinal manipulation for headaches suggest that these approaches may help relieve headaches and may be helpful for migraines.

What Does the Research Show?

• A 2017 review based on five meta-analyses, seven systematic reviews, and 34 randomized controlled trials on complementary and integrative health approaches for headache concluded that acupuncture, massage, yoga, biofeedback, and meditation have a positive effect on migraine and tension headaches. The review also concluded that spinal manipulation, chiropractic care, and hydrotherapy may also be beneficial for migraine headaches.

• Meditation/Hypnotherapy/Relaxation. A 2019 European study conducted in 131 children (9 to 18 years of age) with primary headaches investigated the effectiveness of transcendental meditation or hypnotherapy, and compared them with progressive muscle relaxation exercises (active control group). The study found clinically relevant headache reduction (≥ 50%) in 41% and 47% of children at 3 and 9 months respectively, with no significant differences between the groups.

• Biofeedback. The efficacy of biofeedback has been evaluated in numerous studies for tension headaches, with positive results. However, a 2009 systematic review of 11 randomized controlled trials concluded that there is conflicting evidence on the effectiveness of biofeedback compared with placebo to prophylactic drugs or any other treatment. Several studies have shown biofeedback decreased the frequency of migraines. A 2007 meta-analysis of 55 studies found a modest effect for biofeedback interventions and was seen lasting over an average followup phase of 17 months. However, a 2008 review concluded that biofeedback has beneficial clinical effects for migraine but whether those effects are specific or non-specific remains unclear. A 2016 meta-analysis of five studies involving a total of 137 pediatric participants concluded that biofeedback seems to be an effective intervention for pediatric migraine, but more research is needed to increase the reviewers’ confidence in the estimate.

• Relaxation techniques. A 2017 review found that cognitive behavioral therapy, biofeedback, and relaxation techniques are associated with significant improvements in chronic migraine symptoms. There is limited evidence to support the efficacy of relaxation techniques for tension-type headaches. A 2009 systematic review of eight studies comparing relaxation training to wait list conditions found inconsistent results. Authors of the review concluded that there is no indication, based on current evidence, that relaxation training is better than no treatment or a placebo. A 2008 meta-analysis of 53 studies suggests that relaxation training is less effective than biofeedback. The US Headache Consortium guidelines (85KB PDF) for management of migraines include behavioral and physical treatment recommendations based on evidence from 39 controlled trials. The guidelines indicate that relaxation training, thermal biofeedback combined with relaxation training, EMG biofeedback, and cognitive-behavioral therapy may be considered as treatment options for prevention of migraine and combined with preventive drug therapy to achieve additional clinical improvement for migraine relief.

• Tai chi. Data are too limited to draw meaningful conclusions about whether tai chi is effective for tension-type headaches. One small clinical trial (n=47) suggested that a 15-week program of tai chi was effective in reducing the impact of tension-type headaches when compared to a wait-list control group.
• Acupuncture. The combined results from studies evaluating the efficacy of acupuncture for headaches indicate that acupuncture may provide beneficial clinical effects, but whether those effects of acupuncture treatment are specific or non-specific has not been determined, and is under active investigation. A 2012 individual patient data meta-analysis concluded that acupuncture can be a reasonable referral option for chronic pain conditions, including headache.
• Massage therapy. Limited evidence from two small studies suggests massage therapy is possibly helpful for migraines, but clear conclusions cannot be drawn. A 2011 systematic review of these two studies concluded that massage therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine.
• Spinal manipulation. Findings from numerous systematic reviews on spinal manipulation for headaches are contradictory. A 2011 review concluded that higher-quality systematic reviews are needed before the benefit of spinal manipulation for headaches can be defined.

Safety

• Relaxation techniques are generally considered safe for healthy people; however, there have been rare reports that certain relaxation techniques might cause or worsen symptoms in people with epilepsy or certain mental illnesses, or with a history of abuse or trauma.
• Acupuncture is considered safe when performed by a qualified and competent practitioner using sterile needles. Few complications have been reported. Serious adverse events related to acupuncture are rare, but include infections and punctured organs.
• Tai chi is a relatively safe practice; however, some patients with acute back pain, knee problems, bone fractures, sprains, and osteoporosis may need to modify or avoid certain tai chi postures.
• Side effects from spinal manipulation can include temporary headaches, tiredness, or discomfort in the parts of the body that were treated. A type of spinal manipulation that focuses on the neck has been linked to cervical artery dissections (CAD). These tears are rare but can lead to a stroke. Any kind of sudden neck movement, such as playing sports, getting whiplash, and violent vomiting or coughing may also increase the risk of tears. The available evidence suggests that the incidence of CAD in people getting spinal manipulation is low, but patients need to be informed of this potential risk.

For patients with chronic low-back pain, recent evidence-based clinical practice guidelines from the American College of Physicians (ACP) gave a strong recommendation based on moderate-quality evidence that clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, or mindfulness-based stress reduction. The guidelines also strongly recommend, based on low-quality evidence, tai chi, yoga, motor control exercise, progressive relaxation, biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation.

What Does the Research Show?

• Spinal manipulation. 2017 clinical practice guidelines issued by ACP strongly recommended spinal manipulation, based on low-quality evidence, as initial treatment for patients with chronic low-back pain. A systematic review supporting the 2017 clinical practice guidelines evaluated 32 randomized controlled trials involving more than 6,000 participants and found modest, short-term effects on pain. A 2010 Agency for Healthcare Research and Quality (AHRQ) systematic review concluded that spinal manipulation was more effective than placebo and as effective as medication in reducing low-back pain intensity. The researchers did not find consistent differences when they compared spinal manipulation with massage or physical therapy. A 2011 Cochrane review of 26 clinical trials looked at the effectiveness of different treatments, including spinal manipulation, for chronic low-back pain. The authors concluded that spinal manipulation is as effective as other interventions for reducing pain and improving function. A 2018 pragmatic randomized controlled trial conducted in Europe involving 328 participants with recurrent and persistent low-back pain found that chiropractic maintenance care was more effective than symptom-guided treatment in reducing the total number of days over 52 weeks with bothersome non-specific low-back pain, but it resulted in a higher number of treatments.
• Acupuncture. 2017 clinical practice guidelines issued by ACP strongly recommended acupuncture, based on moderate-quality evidence, as initial treatment for patients with chronic low-back pain. A systematic review supporting the 2017 clinical practice guidelines evaluated 32 randomized controlled trials involving 5,931 participants and found that acupuncture was associated with lower pain intensity and better function compared to no acupuncture treatment. A 2018 review by the Agency for Healthcare Research and Quality (AHRQ) looked at the impact of therapies for chronic low-back pain at least 1 month after the end of treatment. It found that acupuncture was associated with slightly greater effects on pain and function at 1-6 months when compared to controls, such as sham (fake) acupuncture or usual care. One study also found a greater reduction in pain after more than 12 months.
• Massage. A 2015 Cochrane review found evidence that massage may provide short-term relief from low-back pain, but the evidence is not of high quality. The long-term effects of massage for low-back pain have not been established.
• Yoga. 2017 clinical practice guidelines issued by ACP strongly recommended yoga, based on low-quality evidence, as initial treatment for patients with chronic low-back pain. A systematic review supporting the 2017 clinical practice guidelines evaluated 14 randomized controlled trials and found that yoga was associated with lower pain scores, although the effects were small and were not always statistically significant. A 2017 Cochrane review of 12 trials involving 1,080 participants found low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at 3 and 6 months. Yoga may also be slightly more effective for pain at 3 and 6 months, however the effect size did not meet predefined levels of minimum clinical importance.
• A 2018 AHRQ systematic review of noninvasive nonpharmacological treatment of chronic pain concluded that exercise, psychological therapies (primarily CBT), spinal manipulation, low-level laser therapy, massage, mindfulness-based stress reduction, yoga, acupuncture, and MDR improved function and/or pain for at least one month.

Safety

• Side effects from spinal manipulation can include temporary headaches, tiredness, or discomfort in the parts of the body that were treated. A type of spinal manipulation that focuses on the neck has been linked to cervical artery dissections (CAD). These tears are rare but can lead to a stroke. Any kind of sudden neck movement, such as playing sports, getting whiplash, and violent vomiting or coughing may also increase the risk of tears. The available evidence suggests that the incidence of CAD in people getting spinal manipulation is low, but patients need to be informed of this potential risk.
• In people whose pain is caused by a herniated disc, manipulation of the low back appears to have a very low chance of worsening the herniation. For risks associated with spinal manipulation affecting the upper (cervical) spine, see the NCCIH fact sheet Chiropractic: An Introduction.
• Acupuncture is generally considered safe when performed by an experienced practitioner using sterile needles. Reports of serious adverse events related to acupuncture are rare, but include infections and punctured organs.
• Massage therapy appears to have few risks when performed by a trained practitioner. However, massage therapists should take some precautions with certain health conditions. In some cases, pregnant women should avoid massage therapy. People with conditions such as bleeding disorders, thrombocytopenia and those taking anticoagulant medications should avoid forceful and deep tissue massage. Massage should not be done in any potentially weak area of the skin, such as wounds.
• Overall, clinical trial data suggest yoga as taught and practiced in these research studies under the guidance of skilled teacher has a low rate of minor side effects. However, injuries from yoga, some of them serious, have been reported in the popular press. People with health conditions should work with an experienced teacher who can help modify or avoid some yoga poses to prevent side effects.

Available evidence indicates that acupuncture for neck pain may provide better pain relief compared to no treatment. There is some evidence that spinal manipulation may help relieve neck pain, but much of the research on has been of low quality.

What Does the Research Show?

• Manual therapies. Reviews of research on manual therapies (primarily manipulation or mobilization) and acupuncture for chronic neck pain have found mixed evidence regarding potential benefits and have emphasized the need for additional research. A 2015 Cochrane review of 51 randomized controlled trials involving a total of 2,920 participants concluded that there is some evidence to support the use of thoracic manipulation versus control for neck pain, function, and quality of life; however, results for cervical manipulation and mobilization are few and diverse. The reviewers noted that these findings suggest that manipulation and mobilization present similar results for each outcome at immediate-, short-, and intermediate-term followup. Multiple cervical manipulation sessions may provide better relief of pain and improvement in function than certain medications at immediate-, intermediate-, and long-term followup. Because there is risk of rare but serious adverse events for manipulation, more rigorous research is needed on mobilization, and comparing mobilization and manipulation versus other treatment options. A 2007 review noted that clinical guidelines often endorse the use of manual therapies for neck pain, although there is no overall consensus on the status of these therapies.
• Massage therapy. A 2016 review of four randomized controlled trials found that massage therapy may provide short-term benefits from neck pain. However, a 2013 Cochrane review of 15 trials on massage therapy for neck pain showed “very low level evidence” that certain massage techniques may have been effective in reducing pain and improving function. Authors of the review concluded that no recommendations for practice can be made at this time because the effectiveness of massage for neck pain remains uncertain.
• A 2018 AHRQ systematic review of noninvasive nonpharmacological treatment of chronic pain concluded that exercise, low-level laser, Alexander Technique, and acupuncture improved function and/or pain rating for at least one month.

Safety

• Side effects from spinal manipulation can include temporary headaches, tiredness, or discomfort in the parts of the body that were treated. A type of spinal manipulation that focuses on the neck has been linked to cervical artery dissections (CAD). These tears are rare but can lead to a stroke. Any kind of sudden neck movement, such as playing sports, getting whiplash, and violent vomiting or coughing may also increase the risk of tears. The available evidence suggests that the incidence of CAD in people getting spinal manipulation is low, but patients need to be informed of this potential risk.
• Acupuncture is considered safe when performed by a qualified and competent practitioner using sterile needles. Few complications have been reported. Serious adverse events related to acupuncture are rare, but include infections and punctured organs.

Clinical practice guidelines issued by the American College of Rheumatology recommend aerobic exercise and/or strength training, weight loss (if overweight), and a number of pharmacologic and non-pharmacologic modalities for treating osteoarthritis (OA) of the knee, hip, or hand. The guidelines conditionally recommend tai chi, along with other non-drug approaches such as self-management programs and walking aids, for managing knee OA. Acupuncture is also conditionally recommended for those who have chronic moderate-to-severe knee pain and are candidates for total knee replacement but can’t or won’t undergo the procedure.

What Does the Research Show?

• Acupuncture. A 2016 meta-analysis of 10 randomized controlled trials concluded that acupuncture can improve short and long-term physical function, but it appears to provide only short-term pain relief in patients with chronic knee pain due to arthritis. A 2012 meta-analysis concluded that acupuncture can be helpful and a reasonable referral option for OA pain. The authors of the meta-analysis also noted that significant differences between true (actual) and sham acupuncture indicate that acupuncture is more than a placebo; however, these differences are relatively modest. Findings suggest that factors other than the specific effects of needling contribute to the therapeutic effects of acupuncture. In a 2008 systematic review of 10 randomized controlled trials of acupuncture for OA of the knee in 1,456 patients, the authors concluded that these studies provide evidence that acupuncture is an effective treatment for pain and physical dysfunction associated with OA of the knee. A 2010 systematic review of 16 trials of 3,498 patients examined the effects of acupuncture for OA in peripheral joints and found that although acupuncture, when compared to a sham treatment, showed statistically significant, short-term improvements in OA pain, the benefits were small and not clinically relevant. In contrast, acupuncture, when compared to a waiting list control, showed statistically significant and clinically relevant benefits in people with peripheral joint OA.
• Massage therapy. A 2017 systematic review of seven randomized controlled trials involving 352 participants with arthritis found low- to moderate-quality evidence that massage therapy is superior to nonactive therapies in reducing pain and improving functional outcomes. A 2013 review of two randomized controlled trials found positive short-term (less than 6 months) effects in the form of reduced pain and improved self-reported physical functioning. Results of a 2006 randomized controlled trial of 68 adults with OA of the knee who received standard Swedish massage over 8 weeks demonstrated statistically significant improvements in pain and physical function.
• Tai chi. A 2016 randomized, 52-week, single blind comparative effectiveness study involving 204 participants, found that tai chi produced beneficial effects similar to those of a standard course of physical therapy in the treatment of knee osteoarthritis. A 2013 meta-analysis of 7 randomized controlled trials involving 348 participants found that a 12-week course of tai chi provides benefits of improvement in arthritic symptoms and physical function in patients with OA; however, any long-term benefits of tai chi on OA symptoms has not yet been investigated. A 2013 systematic review and meta-analysis of 5 randomized controlled trials involving 252 participants found moderate evidence for short-term improvement of pain, physical function, and stiffness in patients with OA of the knee who practiced tai chi. A 2009 prospective, single-blind, randomized controlled trial of 40 participants found that tai chi demonstrated significantly greater improvement in pain and physical function, as well as improvement in depression, self-efficacy, and quality of life.
• A 2018 AHRQ systematic review of noninvasive nonpharmacological treatment of chronic pain concluded that for knee osteoarthritis exercise, and ultrasound. For hip osteoarthritis, exercise, manual therapies improved function and/or pain rating for at least one month.

Safety

• There are few complications associated with acupuncture, but adverse effects such as minor bruising or bleeding can occur; infections can result from the use of nonsterile needles or poor technique from an inexperienced practitioner.
• Massage therapy appears to have few risks if it is used appropriately and provided by a trained massage professional.
• Tai chi is considered to be a safe practice.

Results from clinical trials suggest that some mind and body practices—such as relaxation, mindfulness meditation, tai chi, and yoga—may be beneficial additions to conventional treatment plans, but some studies indicate that these practices may do more to improve other aspects of patients’ health than to relieve pain.

What Does the Research Show?

• Acupuncture. Acupuncture has been studied for a variety of pain conditions, but very little acupuncture research has focused on RA. A 2017 review identified several studies that have indicated a positive role for acupuncture in the treatment of rheumatoid arthritis, but others have failed to show positive outcomes. A 2010 Cochrane review of two studies—one on acupuncture and the other on electroacupuncture for RA—concluded that acupuncture has no effect on ESR, CRP, pain, patient's global assessment, number of swollen joints, number of tender joints, general health, disease activity, and reduction of analgesics. Although findings from the study on electroacupuncture showed that electro-acupuncture may reduce symptomatic knee pain, the review noted that the poor quality of the trial, including the small sample size, preclude its recommendation.
• Mindfulness, biofeedback, and relaxation training. A 2017 review of three randomized controlled trials found that although there is increasing evidence linking the practice of mindfulness techniques to improved immune function, there haven’t been enough large, high-quality studies to determine long-term effects in rheumatic disease. A 2010 systematic review of 31 studies in 2,021 patients looked at the benefits of mind and body practices such as mindfulness meditation, biofeedback, and relaxation training on the physical and psychological symptoms associated with RA. There was some evidence that these techniques may be helpful, but overall, the research results have been mixed.
• Tai chi. A few small studies have been conducted on tai chi for RA. A 2007 systematic review concluded that tai chi has not been shown to be effective for joint pain, swelling, and tenderness, although improvements in mood, quality of life, and overall physical function have been reported. A small 2010 study of 15 participants found that tai chi improved lower-limb muscle function post-treatment and at the 12-week followup; however, there was no evidence that it reduced disease activity or pain.
• Yoga. A 2018 meta-analysis of 13 trials involving a total of 1,557 participants with knee osteoarthritis and rheumatoid arthritis found that regular yoga training was helpful in reducing knee arthritic symptoms, promoting physical function, and general wellbeing in arthritic patients. A 2017 review of two studies found some beneficial effect on pain, but due to the high risk of bias in both studies, the reviewers gave a weak recommendation for yoga in rheumatoid arthritis. Yoga incorporates several elements of exercise that may be beneficial for arthritis, including activities that may help improve strength and flexibility. A 2013 systematic review of 8 randomized controlled trials involving a total of 559 participants found very low evidence on the effects of yoga on pain associated with RA.

Safety

• Acupuncture is considered safe when performed by a qualified and competent practitioner using sterile needles. Few complications have been reported. Serious adverse events related to acupuncture are rare, but include infections and punctured organs.
• Some people have reported soreness, but most studies have found that tai chi is relatively safe for people with RA.
• People with RA who have limited mobility or spinal problems should perform yoga exercises with caution. People with RA may need assistance in modifying some yoga postures to minimize joint stress and may need to use props to help with balance.

Chronic pain is a common problem, affecting one of every five U.S. adults. Some complementary health approaches have been shown to have modest benefits for chronic pain, but the amount and quality of evidence varies for different approaches and pain conditions.

1. In general, research on complementary approaches for fibromyalgia is preliminary. However, there’s encouraging evidence that practices such as tai chi, qigong, massage therapy, acupuncture, and balneotherapy (spa therapy) may help relieve some fibromyalgia symptoms.

2. Some mind and body practices, such as relaxation training, biofeedback, acupuncture, and spinal manipulation, may be helpful for headaches and migraines. Preliminary studies suggest that certain dietary supplements, including the herb feverfew, the vitamin riboflavin, the mineral magnesium, and coenzyme Q10, may be helpful for migraines. The herb butterbur seems to reduce migraine frequency, but serious concerns have been raised about its possible liver toxicity.

3. There haven’t been many large, well-designed studies on complementary approaches for irritable bowel syndrome, but some evidence suggests that peppermint oil may have modest, short-term benefits and that gut-directed hypnotherapy may be a helpful form of psychological therapy. Probiotics have been studied for irritable bowel syndrome, but the current evidence does not clearly show which types of probiotics might be helpful.

4. There’s low- or moderate-quality evidence that a variety of psychological or physical complementary health approaches, including acupuncture, electromyography biofeedback, low-level laser therapy, mindfulness-based stress reduction, progressive muscle relaxation, spinal manipulation, tai chi, and yoga, may be helpful for chronic low-back pain. Topical preparations of the herb cayenne may also help to relieve low-back pain.

5. There’s evidence that acupuncture can be helpful for neck pain. Spinal manipulation might also be helpful, but much of the research on this practice has been of low quality. Massage therapy may be helpful for neck pain, but the effects may only last for a short time.

6. Tai chi may be helpful for pain from osteoarthritis of the knee or hip. Other complementary approaches that have shown promise for osteoarthritis include acupuncture and yoga. 

7. Psychological and physical approaches—such as relaxation, mindfulness meditation, tai chi, and yoga—may be beneficial additions to rheumatoid arthritis treatment plans, but they may do more to improve other aspects of patients’ health (such as quality of life) than to relieve pain. For example, tai chi may improve mood and overall physical function, and mindfulness meditation may improve patients’ ability to cope with pain. Dietary supplements containing omega-3 fatty acids, gamma-linolenic acid, or the herb thunder god vine may help relieve some rheumatoid arthritis symptoms.

8. Acupuncture, reflexology, or acupressure may be helpful for cancer pain, and acupuncture has also been shown to relieve joint pain caused by treatment with aromatase inhibitors. Hypnotherapy may reduce pain associated with procedures used in cancer diagnosis or treatment. Massage therapy may be helpful for patients who have pain during palliative or hospice care.

9. As with any treatment, it is important to consider safety before using complementary health approaches. If you’re considering a complementary approach to help manage your chronic pain, talk with your health care providers first.

What kind of magnets are used for pain?

Magnets and magnetic therapy have been used to treat different types of pain, such as arthritis or headaches, for hundreds of years. Magnetic therapy devices are marketed widely, and they are most commonly used for pain, inflammatory conditions, and wound healing. Different types of magnets have been studied for pain:

• Static or permanent magnets: Made from metal or alloys, static magnets can be weak, moderate, or strong, but their magnetic fields are always on and do not change. Magnetic therapy using static magnets involves placing magnets near or on the body for the purpose of pain relief or healing. Static magnets marketed for pain are often encased in a wrap, such as a wristband, that is placed against the skin near where pain is felt. They are also sold in products such as jewelry, mats, pillows, and bed pads. The existing research on the use of static magnets for pain is extremely limited, and no conclusive evidence of static magnets’ effectiveness for any form of pain has been found.
• Electromagnets: The magnetic fields in electromagnets can change in intensity and are created when an electric current passes through a wire coil containing magnetic material. Devices with electromagnets in them are marketed for health purposes. Among the types of electromagnets studied for pain or healing are pulsed electromagnetic field therapy (PEMF) and its subtypes, including repetitive peripheral magnetic stimulation. Current research suggests that electromagnetic field therapy can relieve pain and improve function in patients with various musculoskeletal pain conditions and some osteoarthritis conditions, although the data is mixed. Electromagnetics appear to be safe for treating pain.

Is magnetic therapy approved by the U.S. Food and Drug Administration (FDA)?

Magnetic therapy using PEMF has been approved by the FDA for specific conditions, including treatment of fractures that do not heal with standard medical treatment and post-operative pain and edema in superficial soft tissues. For severe migraines, depression, and obsessive-compulsive disorder, the FDA has approved a specific type of magnetic therapy known as transcranial magnetic stimulation, which uses magnetic fields to stimulate brain cells. The use of FDA-approved magnetic therapy for these conditions is considered conventional medicine and is beyond the scope of this fact sheet.

Do magnets help with pain?

Research studies do not conclusively support the use of static magnets for pain relief. There is some evidence that electromagnetic therapy may be helpful for pain.

Electromagnetic therapy

A 2020 review of 21 studies (1,101 participants) that focused on electromagnetic therapy for musculoskeletal pain conditions reported that electromagnetic therapy reduced pain and improved function in people with different musculoskeletal diseases, including knee osteoarthritis (8 studies), shoulder impingement syndrome (2 studies), chronic mechanical neck pain (1 study), low-back pain (4 studies), fibromyalgia (3 studies), patellofemoral (knee) pain (1 study), plantar fasciitis (heel pain, 1 study), and hand osteoarthritis (1 study). Although most of the studies in the review compared electromagnetic therapy with a sham (i.e., fake) treatment, a few looked at it in combination with other forms of therapy. The review concluded that pain relief was not further increased when electromagnetic therapy was used along with other physical therapies such as hot packs, therapeutic ultrasound, or transcutaneous electric nerve stimulation (TENS).

Static magnet therapy

A 2021 review of 7 studies (576 participants) on the use of static magnets for various types of pain—including diabetic neuropathy, sciatica, fibromyalgia, plantar heel pain, pelvic pain, neck and shoulder pain, or forearm and wrist pain—had mixed results. Four studies showed improvements in pain and three did not. Different studies used different static magnet strengths or dosing times, which may have contributed to the inconsistency in the results.

Osteoarthritis

Electromagnetic therapy

Electromagnetic therapy may be a beneficial complementary therapy for treating osteoarthritis in certain joints, although the evidence on specific symptom relief is mixed.

• A 2020 review of 15 studies (985 participants) found that electromagnetic therapy reduced pain and improved stiffness and physical function but not overall quality of life in people with osteoarthritis in their knees, hands, neck, or ankles.
• A 2018 review of 12 studies (385 participants) that looked at people with osteoarthritis in various areas of the body, including knees (10 studies), neck (2 studies), and hands (1 study), found that treatment with electromagnetic therapy reduced pain and improved function in people with knee and hand osteoarthritis but not neck osteoarthritis. Short sessions (less than 30 minutes) were more effective than longer sessions.

Static magnet therapy

There is no conclusive evidence that static magnet therapy is beneficial for osteoarthritis pain.

Fibromyalgia

The evidence on magnetic therapy for fibromyalgia pain is very limited and weak. A 2021 narrative review of four studies (312 participants) on electromagnetic and static magnet therapy for fibromyalgia reported that there is not enough evidence to know if magnetic therapy is helpful for reducing pain in people with fibromyalgia. The two smallest studies (93 participants) in the review found evidence of pain reduction using 30 minutes of electromagnetic therapy two to three times per week for 3 to 4 weeks. However, the largest study of electromagnetic therapy for fibromyalgia pain (108 participants) found no reduction in pain in women with fibromyalgia after PEMF. The one study of static magnet therapy (111 participants) included in the review found that 6 months of sleeping on mattress pads containing static magnets did not improve pain significantly in people with fibromyalgia.

Low-Back Pain

Electromagnetic therapy

There is some evidence that electromagnetic therapy may help improve low-back pain. A 2022 review of 14 studies (618 participants) found that 1 to 12 weeks of PEMF therapy, 2 to 7 days per week, is beneficial for reducing pain in people with chronic low-back pain. In addition, the researchers found that PEMF may provide additional pain relief even when used along with usual care, physical therapy, or pain medicines.

Static magnet therapy

Very little evidence is available on static magnet therapy for low-back pain. A small 2021 pilot study (22 participants) reported that when magnetic tape was applied to their backs, participants with low-back pain had improved blood flow and reported reduced pain.

Shoulder Pain

Electromagnetic therapy

The small amount of research that has been done on electromagnetic therapy for shoulder pain has not shown that this therapy is helpful.

• A 2016 review of 4 studies (168 study participants) of PEMF for shoulder pain from rotator cuff disease reported that PEMF therapy was not effective for reducing shoulder pain either alone or when added to a physical therapy exercise program.
• A 2021 study (40 participants) of people with a shoulder tendon/rotator cuff tear found that combining PEMF with conventional physical therapy did not reduce pain or improve function any more than physical therapy alone.

Static magnet therapy

No recent research is available on static magnet therapy for shoulder pain.

Complex Regional Pain Syndrome

Electromagnetic therapy

A small amount of research has reported mixed results on the effectiveness of PEMF for people with complex regional pain syndrome (CRPS). CRPS is a broad term describing excess and prolonged pain and inflammation that follows an injury to an arm or leg.

In a 2021 review of 2 studies (70 participants) on PEMF therapy for people with CRPS, 1 study found that PEMF did not reduce pain or swelling. However, the other smaller study found that people with CRPS had less pain and improved function in their upper and lower limbs after 10 consecutive days of a type of PEMF therapy known as bio-electro-magnetic-energy-regulation (BEMER).

Static magnet therapy

No recent research is available on static magnet therapy for CRPS.

Mouth and Jaw Pain

Electromagnetic therapy

No recent research is available on electromagnetic therapy for mouth and jaw pain.

Static magnet therapy

Very little research is available on magnetic therapy for pain in and around the mouth and jaw. A small 2012 study (79 participants) found that 5 minutes of static magnetic therapy reduced pain in people with jaw pain (temporomandibular disorders) but not dry socket (alveolitis) or mouth ulcers. This study only looked at pain levels immediately after using the magnets. No information is available about whether magnetic therapy is effective for reducing pain over any length of time.

Carpal Tunnel Syndrome Pain

Electromagnetic therapy

No recent research is available on electromagnetic therapy for carpal tunnel syndrome pain.

Static magnet therapy

Not much research is available on magnetic therapy for carpal tunnel syndrome pain. A small 2018 study (22 participants) concluded that 6 weeks of static magnets did not reduce pain significantly in people with carpal tunnel syndrome.

Menstrual Pain

Electromagnetic therapy

There is a small amount of recent research on electromagnetic therapy for dysmenorrhea (menstrual pain). A 2020 study (40 participants) that compared PEMF therapy with aerobic exercise in adolescents and young women diagnosed with dysmenorrhea found that 4 weeks of PEMF therapy, received for 15 to 25 minutes per session, three times per week, reduced menstrual pain significantly more than 20 to 25 minutes of aerobic exercise performed three times per week for 4 weeks. The participants who received PEMF also reported better quality of life than those who exercised.

Static magnet therapy

No recent research is available on static magnet therapy for menstrual pain.

Cancer and Pain from Chemotherapy

The small amount of research that has been done on electromagnetic and static magnet therapy for pain related to cancer and chemotherapy treatments has not shown a beneficial effect. The quality of the reviewed studies was low due to their small sizes and short durations.

Electromagnetic therapy

A 2018 review of 2 studies (64 participants) of PEMF therapy for peripheral neuropathic pain caused by chemotherapy in people with cancer did not find a significant effect.

Static magnet therapy

A 2020 study (60 participants) of people with advanced lung cancer found that receiving 21 days of rotating static magnetic therapy (2 hours per day) did not reduce pain from chemotherapy.

Multiple Sclerosis and Paresthesia Pain

Electromagnetic therapy

One small 2016 study (63 participants) on electromagnetic therapy for multiple sclerosis–related paresthesia pain (i.e., an abnormal itching, prickling, tingling, burning, or numbness in the limbs) found that 60 days of twice weekly PEMF therapy for 20 minutes per session was effective in reducing pain in people with multiple sclerosis. A smaller reduction in pain was also found after 30 days of PEMF treatment.

Static magnet therapy

No recent research is available on static magnet therapy for paresthesia pain from multiple sclerosis.

Are magnets safe to use for pain?

Both static and electromagnetic therapy appear to be safe for treating pain. Many studies have reported minimal or no negative side effects in people following magnetic therapy, including people with chronic diseases and pain.

Magnets and magnetic therapy devices should be kept out of reach of children, as children may swallow or accidentally inhale small magnets, which can be deadly.

You should keep the following safety concerns in mind before trying and while using magnetic therapy:

• Some magnets may interfere with medical devices, such as pacemakers and insulin pumps.
• If you’re pregnant or you have a health condition, talk with your health care provider before using magnetic therapy.
• Magnetic bracelets, necklaces, braces, or other devices should be removed from the body before you have an imaging procedure such as magnetic resonance imaging (MRI).
• Do not use static magnets or electromagnets that you can buy without a prescription to postpone seeing a health care provider about pain or any other medical problem.