BOOK REVIEW: Pain: Considering Complementary Approaches by NCCIH

Pain: Considering Complementary ApproachesPain: Considering Complementary Approaches by National Center for Complementary and Alternative Medicine
My rating: 4 of 5 stars

Online here


The National Center for Complementary and Integrative Health (NCCIH) has put out a new edition (dated 2019) of its pamphlet (about 50 pages) about how useful various complementary practices are in helping patients reduce, or cope with, pain. The NCCIH is a center in the National Institutes of Health (NIH) that serves as a clearinghouse for information about how alternative and complementary practices perform in treatment of various ailments. While alternative (instead of mainstream medicine) and complementary (in conjunction with mainstream medicine) are quite different, in almost all cases this work herein is reporting on the latter basis. The complementary practices in question include: yoga, taiji, meditation and mindfulness, massage, acupuncture, chiropractic manipulation, relaxation methods, and others.

Complementary approaches to treatment of pain is a particularly salient topic these days as the mainstream medical approach (giving patients pills to gobble down) has resulted in what many have called a “crisis” of opiate addiction. So, if it’s possible to reduce the grip of pain with practices that at best have numerous other health benefits and at worst do no harm, than that’s a pretty good outcome.

Chapters three through eleven form the pamphlet’s core, and all but the last of those look at one complementary practice each, including (in order): acupuncture, massage, meditation, relaxation techniques, spinal manipulation, taiji (a.k.a. tai chi, or tai chi chuan), yoga, and dietary supplements and herbs. Chapter 11 discusses a few additional (less popular) practices. These chapters follow a three-prong approach: 1.) is it safe? 2.) does it help mitigate pain? and 3.) where can I find more information? [Spoiler alert: In almost all cases the answer to #1 is roughly “Yes, for most people, but possibly not for you. Check with your doctor,” and to #2 is usually something like: “there is some preliminary evidence that in certain cases certain people may have benefited.”] The chapters before (ch. 1 & 2) and after (ch. 12 to 14) provide background context and additional information.

On the positive side, it’s great that this information has been gathered together and packaged into a readable format with pictures and easy to read text.

On the down side, this was clearly a document put together by a committee of bureaucrats in consultation with lawyers. It is so laden with qualifiers and spongy speak that it’s impossible to discern how strong the evidence is for the various practices or how one compares to another. I felt that they could have given the same information in a three-column table in which the first column is the practice, the second column is “can’t hurt to try*” [*provided your physician concurs,] and the third column would be “nah, this stuff is fake.” [Spoiler alert: almost everything besides homeopathy would have the first column checked, but the consensus seems to be that homeopathy is pseudo-scientific quackery designed to sell water at medicinal prices.]

This booklet is available on the web for free, so if you’re interested, check it out. But don’t expect to come away with any profound insights. It’s not that kind of booklet.

View all my reviews

BOOK REVIEW: The Modern Art and Science of Mobility by Aurlien Broussel-Derval & Stephane Ganneau

The Modern Art and Science of MobilityThe Modern Art and Science of Mobility by Aurelien Broussal-Derval
My rating: 5 of 5 stars

Amazon page


This book is designed to help athletes (and those who train athletes) increase mobility. The authors draw heavily upon yoga and martial arts drills (especially judo and jujutsu groundwork drills) in addition to the usual suspects of modern fitness – i.e. calisthenics, kettlebell, etc. It’s a visual book. The text is highly distributed toward the first half of the book. The heart of the book is pictures and descriptive captions of the exercises and practices described. This isn’t a complaint. I think there is sufficient discussion of the topics addressed and that said discussion was clear.

The book is organized into four parts, and — within each part — by anatomical region. The four parts are: Pain, Breathing, Movement, and Mobility. The section on pain offers many self-massage techniques, often using foam rollers or balls to counteract myofascial pain. I was particularly impressed to see an entire section devoted to breathing, and that it not only explored exercises to free up the diaphragm and intercostals (rib muscles) but also discussed issues such as the role of stress on breath. As mentioned the parts on movement and mobility are heavily oriented toward conveying exercise sequences graphically, and the chapters were oriented by parts of the body.

With a book that is so graphically-oriented, it’s important to mention that the photography, anatomical drawings, and diagrams are well done. The photos make it easy to see what is happening. It seemed to me that they used the right number of photographs to convey the movements involved, and they augmented these with arrows and lines to show direction of movement and alignments. It was usually quite clear what the movement was even before reading the captions. The photos are of varied sizes and orientations as needed to convey the exercise at hand. The anatomical drawings are clearly labeled.

I will say there were three exercises that I found troubling, but I gave the authors the benefit of the doubt as the book seems to be directed toward athletes. I don’t think these are things that will give most athletically-built people too much trouble especially when practice in moderation. However, as anyone may pick up such a book, I would be cautious of these three activities – especially if you haven’t been training in a while or are new. First, doing loaded lunges (i.e. barbells across the shoulders) with one’s knee way out forward of the toes. As the point of the book is mobility, I don’t have a problem with doing floor exercises on a knee this way, but that’s a lot of pressure to load onto connective tissue. Second, doing cobra (Bhujanga, or what they call “Sphinx”) with straightened arms and thighs resting on the floor. That almost always creates a sharp kink in the back with one spinal process prying into another. One can do Up-Dog (Urdhva Mukta Svanasana) with thighs off the ground or Cobra (Bhujanga) with your navel on the ground, but you shouldn’t confuse the two. Finally, they mention doing a roll up into shoulder stand. Unless you are extremely experienced, this is a bad idea because with the chin tucked into the chest there is very little room for error. Work up into shoulder stand slowly and easily. I will point out that this is what I noticed as a yoga teacher, individuals with other experience may see other issues, but I have some experience with the jujutsu drills and didn’t notice anything problematic.

That said, I thought this book was well done. The organization, explanations, and graphics were excellent and it will be a helpful resource for athletes working on mobility issues.

View all my reviews