Complementary therapies for bone health

A wide range of treatments fall under the term complementary and alternative therapies. Each has its own unique theory and practice.

Complementary and alternative treatments aim to support recovery and wellbeing by 'complementing' standard medical treatment. For some people, they provide a non-medical 'alternative' to traditional medicine.

These therapies often take a 'holistic' approach. This means they aim to treat the whole person and support both physical health and mental wellbeing. From a holistic viewpoint, the body works as one system, and things like diet and stress can affect your general health and wellbeing.

Many complementary and alternative therapies come from Eastern health traditions, so they may be different from typical healthcare in the UK.

In the past, Western medicine and complementary therapies were seen as separate. However, they are now sometimes used together in NHS settings, such as hospices, as part of a more holistic approach to care.

There is no simple answer to this question, as the safety of complementary therapies depends on the type of therapy and any conventional treatments you may already be taking. Although many complementary approaches have good safety records, this does not mean they are risk-free for everyone.

The following tips will help you to be as safe as you can:

• If you are thinking about using a complementary therapy, check with your doctor or nurse first to make sure it is safe for you. This is especially important if the therapy includes dietary supplements such as vitamins, minerals, or herbal products.

• Some complementary therapies, such as herbal medicines, may affect how well conventional medicines work. If you are already taking medicines, you can also ask your pharmacist for a Medicines Use Review (MUR) to discuss all your medicines and check for possible interactions.

• It is also important to remember that therapies can sometimes cause side effects. You should find out about possible side effects before starting any treatment. A product is not necessarily safe just because it is called “natural”.

• Always tell your therapist about your medical history before starting treatment. For example, if you have osteoporosis, you may be at higher risk of broken bones, so this should be discussed.

• Make sure you choose a therapist who is properly qualified and belongs to a recognised professional organisation. Most complementary practitioners in the UK are not regulated by law (except chiropractors and osteopaths), but some therapies such as acupuncture, homeopathy, and medical herbalism do have professional bodies, although membership is optional.

• Medicines sold in the UK must be licensed by the Medicines and Healthcare products Regulatory Agency (MHRA). Some herbal products are registered under the Traditional Herbal Registration (THR) scheme, shown by a leaf logo, which means they meet quality standards and have been used traditionally for at least 30 years.

The THR scheme applies to products sold in UK shops and online. However, the MHRA warns against buying herbal remedies online from untrusted websites, as they may not be safe.

At present, there is not enough evidence to show that complementary therapies can strengthen bones or reduce the risk of fractures in a scientifically proven way.

Some studies suggest that certain complementary therapies may help with pain.

Even though there is limited evidence that they improve bone strength, some people report benefits because these therapies can improve their quality of life. This can be important to them for different reasons:

• They may help improve relaxation and reduce stress, which can support overall wellbeing.

• Some people feel they have more control over their health and treatment when using a complementary approach.

• People may find comfort in the time, attention, and care given by a therapist.

• Some prefer treatments they see as more “natural”.

• Some people cannot tolerate conventional medicines and want other options to try.

• Personal beliefs about health, illness, and treatment may make these approaches more meaningful, especially for long-term (chronic) conditions.

Natural progesterone

The main ingredient in “natural progesterone” products is a plant hormone progestogen which is extracted from wild yams. It is thought to be similar to the natural hormone, progesterone, produced in the body. Natural progesterone creams that can be rubbed into the skin and absorbed are claimed to help with menopausal symptoms, prevent osteoporosis and strengthen bones. The creams are marketed as offering women an alternative option to medicines for osteoporosis.

One American research study investigated the effects of natural progesterone cream on both menopausal symptoms and bone density. Although it seemed effective in controlling hot flushes, there was no effect on bone density observed in the first year. This has been confirmed by a small, well designed British trial which, compared the effect of the progesterone cream to the identical looking placebo cream and a standard hormone replacement therapy (HRT) skin patch. Results showed no significant changes in bone density over two years in either of the cream groups although menopausal symptoms showed improvement. This study by Southampton University has been presented at major osteoporosis conferences. In summary, there is no evidence that natural progesterone improves bone strength.

Natural progesterone cream should not be used as an alternative to the standard synthetic progestogens used in combined (oestrogen plus progestogen) hormone replacement therapy (HRT). Although there are some side effects associated with the use of synthetic progestogens in various HRT preparations, natural progesterone is an unlicensed product and may not protect the womb lining from increased cancer risks caused by giving oestrogen on its own.

Homeopathy

The central principle of homeopathy is that “like cures like” and by using much- diluted remedies, the body’s energy and its own natural healing mechanisms are activated.

The effectiveness of homeopathy has been widely studied although not specifically to prevent bones from breaking. Although some benefits following homeopathy treatment have been reported it has never been proven that the remedy itself has been responsible. However you may feel benefit from the whole-person care offered by this system of medicine.

Homeopathy is available on the NHS in some areas of the country and at the NHS homeopathic hospitals in London and Glasgow, but as with all NHS services, this remains under review. In the UK, around 400 GPs practise homeopathy alongside traditional medicine and treat around 200,000 NHS patients every year.

Homeopathic medical doctors are regulated by their professional medical organisation (GMC), and are registered with the Faculty of Homeopathy. Non-medically trained homeopaths usually belong to a registering organisation that require their members to have attained a recognised qualification in homeopathy, have insurance and undertake some form of continuing professional updating.

If you try homeopathy, ask the advice of a qualified, registered homeopath and check with your pharmacist first before purchasing an over-the-counter remedies. Tell the homeopath if you are taking any prescribed medicines.

Herbal Medicine

Herbal medicine is one of the oldest forms of medicine. Various parts of medicinal plants (leaves, stems, buds, flowers or roots) are used and some will have formed the basis for many of our modern medicines.

Although most herbs have not been studied in terms of their effect on bone health or fracture risk, it is claimed that some herbs might provide extra calcium, others might regulate the body’s use of calcium, assist in bone healing or have oestrogen like effects (these are called phytoestrogens) that might improve bone strength. In general, although individual herbs may have shown some effects in laboratory studies, there is no conclusive scientific evidence that herbal remedies are effective and will improve bone health or make fractures less likely.

As the quality (and strength) of herbal remedies from outside the UK might vary, all herbal products for sale in UK shops and from online retailers are required to carry the THR logo (a mark of registration, explained above). Unlike licensing for mainstream medicines, registration shows the herbal medicine has a license to be sold rather than giving proof of its effectiveness. An authorised herbal practitioner however doesn’t need a license and can still continue to prescribe patients with individual herbal medicines which are made up in their own clinics. Further information and a list of practitioners can be obtained from the National Institute of Medical Herbalists in the ‘contacts’ list below.

Traditional Chinese medicine focuses on balancing the “life force” energy known as ‘Qi’ (pronounced “chee”) in the body by using a mixture of herbs, non-plant based components and dietary changes. Traditional Chinese medicine practitioners believe that when Qi does not flow freely through the body, this can cause illness and that by restoring the flow of Qi health can be restored.

A large review of all the relevant clinical studies of Chinese herbal medicines to 2014 found that despite possible effects on cells under laboratory conditions, the benefits in terms of improving bone strength in humans is unproven.

Acupuncture

Acupuncture involves the stimulation of certain sites in the body by very fine needles being inserted into the skin. The treatment which originated in China many years ago, claims to bring relief of symptoms both close to the needles and in more distant parts of the body. Traditional acupuncture is believed to restore the free flow of Qi through the body in channels called meridians and so help to restore health.

There have been some small studies of the potential effects of acupuncture on bone building cells and sex hormone levels but its benefits on bone health are unproven.

If you use a private acupuncturist check they are registered with the British Acupuncture Council or another recognised professional body. The British Acupuncture Council represent the largest group of practitioners and hold a nation-wide register.

Touch and pressure therapies

There are no claims that touch and pressure therapies will improve bone health.

Tai Chi is an ancient form of Chinese martial arts; it uses the principles of deep breathing and relaxation combined with slow controlled movements which can help improve posture and balance. Some classes teach a type of seated Tai Chi which can be enjoyed by anyone wishing to practice and have the benefits of Tai Chi, sitting down.

Studies have looked into the potential benefits of Tai Chi for people with osteoporosis, but there is currently no convincing evidence that Tai Chi can prevent or treat the condition. Some research has studied the effect of Tai Chi in reducing the risk of falls among older adults who are at increased risk but the results aren’t clear and more research is needed. Tai Chi though may reduce falls risk in the younger less-frail older person.

It isn’t possible to provide information on all the numerous complementary therapies available and whilst there may be no direct evidence of these improving bone health, these may still have a positive benefit on how you manage your general health and well-being.

There is no one way of managing health that suits everyone, but it’s important to find a path that suits you best as an individual and review things from time to time. Through positive thinking we can help create a better experience of managing our health.

Research shows that a healthy lifestyle has a positive effect on bone, at all ages. This includes a healthy, well balanced diet, plenty of exercise and keeping active in later life, safe sunlight exposure to provide vitamin D and avoiding smoking and excessive levels of alcohol. These measures are important in helping to maintain healthy bones and can adequately support bone health in individuals at low risk of a fracture.