ALTERNATIVE NON-SURGICAL TREATMENTS
In the absence of reliable evidence, the work group cannot recommend for or against the use of the following:

Acupuncture
Dry needling
Cannabis
Cannabodiol (CBD) oil
Capsaicin
Shark cartilage
Glucosamine and Chondroitin
Cupping
Transcutaneous Electrical Nerve Stimulation (TENS)

Rationale

Data regarding the use of complementary and alternative medicines (CAMs*) for the management of GJO is lacking. The peer reviewed literature does not provide credible evidence that the above modalities provide benefit or harm to patients with GJO. In view of these deficiencies, we cannot support or restrict the usage of the above alternative treatment options when managing symptomatic GJO.

*CAMS: acupuncture, dry needling, cannabis, CBD oil, non-prescription pain patches, capsaicin, shark cartilage, glucosamine and chondroitin, cupping

 

Strength of Evidence (evidence quality): No reliable evidence

 

Benefits & Harms:

Unable to assess due to lack of evidence from peer reviewed literature

 

Future Research:

Randomized controlled trials comparing complementary and alternative medicines to accepted medications and/or control group (placebo) would provide helpful data substantiating non-inferiority. Potential barriers to comparative studies include, but are not limited to, state and federal laws and regulations, funding, and heterogeneity of study design (i.e. number of treatment arms, dosages and durations of treatment, power analysis, patient reported outcomes).


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