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As Penny Peoples recently examined her flower gardens—the dahlias were spectacular this summer—she was thankful for how far she has come in the past few months. At the beginning of the year, she suffered back and leg pain so intense that she couldn't leave her home and was barely able to care for herself.
Steroid injections eased the worst of the pain, but she still couldn't climb stairs easily, drive or participate in other day-to-day activities. Peoples turned the corner when she found herself at BWH's Osher Clinical Center, where she began receiving regular chiropractic care, acupuncture and other therapies.
"I've been enormously helped," said Peoples, who also receives physical therapy. "I still have a small amount of pain, but I was able to go back to gardening and being quite active. I'm incredibly grateful for the care I receive at the Osher Clinical Center."
Integrative and complementary therapies like acupuncture, craniosacral therapy, tai chi and herbal supplements are helping patients to achieve and preserve good health. The Osher Clinical Center, which opened in 2007, provides multiple therapies that can enhance conventional medical treatments for the prevention and management of disease.
Although many patients have experienced positive results from these therapies for years, there isn't yet substantial scientific evidence linking integrative therapies to outcomes. A group of researchers at the Osher Center for Integrative Medicine at Harvard Medical School and BWH, which collaborates with the Osher Clinical Center, are working to change that by conducting studies on such therapies as acupuncture and chiropractic care.
"At the Brigham, we focus on wellness in all its complexities, from treating disease and sickness to preventing it," said Barbara Bierer, MD, senior vice president of Research. "Our focus on care at the Osher Clinical Center and elsewhere must be informed by scientific evidence; it is our job to provide that evidence through research."
Established by a generous gift from the Bernard Osher Foundation, the Osher Clinical Center is distinguished by its integrative medicine approach to all health conditions. It has particular interest in treating back pain, women's health issues, non-pharmacologic management of common medical problems and issues of prevention and wellness.
This month, the center launched a new program to coordinate the care of patients who suffer back pain. Patients will be treated with chiropractic, acupuncture and a variety of hands-on mind-body and movement therapies. If needed, their care can be combined with traditional pain management, physiatry and physical therapy. Those who require surgery will be quickly referred to an expert at BWH.
One of the Osher Clinical Center staff members who may see back pain patients is licensed massage therapist Arthur Madore, LMT. His work in massage, postural alignment and movement education is designed to help patients understand how to improve their function and reduce pain.
"When people have back pain, for example, it's often compounded by habits," Madore said. "I help them identify what they're doing poorly, such as how they move when they drive long distances, walk, vacuum or lift a baby."
In the area of women's health, the center offers integrative therapies that may help patients undergoing fertility treatment as well as those who are already pregnant and advised to avoid medications. For the management of common health problems such as hypertension, the center can help patients make lifestyle and dietary changes.
"There are also dietary supplements people can take, such as magnesium and lycopene, that can be very helpful," said Medical Director Don Levy, MD. "I've had people able to cut their blood pressure medications in half with the use of these interventions"
The center also offers a Mind-Body Program for Health and Fertility—an eight-week course that helps women optimize their chances for successful pregnancy through various integrative and stress reduction techniques.
Patients undergoing therapies offered by the Osher Clinical Center and similar centers around the world have experienced promising results, but there is limited scientific evidence about the outcomes of these therapies.
"When you hear of acupuncture, prayer, tai chi – they have a long history of use but not the scientific evidence to demonstrate they're effective," said Julie Buring, ScD, an epidemiologist who is serving as interim director for the Osher Center for Integrative Medicine, while the search for a director is underway. "There also tends to be a polarization – people count or discount these therapies completely with little evidence on either side. These therapies need and deserve the same level of evaluation as conventional therapies do."
Buring, who has led major clinical trials including the Women's Health Study, and Peter Wayne, PhD, are conducting that research as part of the Osher Center for Integrative Medicine. The research arm of the center was established in 2001 through a major endowment from the Bernard Osher Foundation.
Wayne, the newly-appointed research director, is a widely-published author on topics including the evaluation of acupuncture for stroke recovery and endometriosis-related pelvic pain, as well as the evaluation of tai chi for chronic heart failure.
Buring and Wayne have already launched a three-pronged study on back pain. They will collect information from every patient who comes in to the Osher Clinical Center with back pain to find out whether they had spoken to their primary care physician about seeing complementary therapy practitioners, what barriers or facilitators they experienced in coming to the clinic and what they think of the therapies they are receiving.
The study will also survey physicians at BWH to determine what kind of scientific evidence they would wish to have in order to refer patients to the Osher Clinical Center. The third part of the study will compare outcomes for patients with back pain treated at the center and other BWH clinics.
"I appreciate any intervention that could help patients, but we need solid evidence," said Wayne, who is also a tai chi practitioner and teacher. "With my background in science and my personal interest in integrative therapies, I felt I might be able to help bridge a chasm. I want to use the lens of science to objectively evaluate and pique the interests of health care providers and insurers to integrative therapies. And only one thing will help us do that – the type of scientific evidence that the Osher Center for Integrative Medicine is committed to providing."