You Use That Stuff, Too?

Massage

In the NCCAM survey, 5 percent of respondents reported using massage therapy in the last year.

Small studies have suggested that massage can reduce anxiety and perception of pain in cancer patients, promote sleep in critically ill patients and increase relaxation, energy and mobility in residents of long-term care facilities, but most studies on massage haven't been replicated in an effort to confirm their findings. One 2003 review published in the Annals of Internal Medicine found that massage is effective for chronic back pain, but a 2004 review by Edzard Ernst in the Clinical Journal of Pain found insufficient evidence to recommend massage for controlling musculoskeletal or other pain.

NIH nurse Jim Nichols finds massage helpful for people with terminal illnesses and chronic pain. "A lot of times when I work with people with terminal illnesses, they tend to take their mind away from their body," Nichols said. "What I try to do is let them reconnect with themselves and be able to calm down and come back into their body."

A 2003 review in the journal Rheumatology found that although massage is not entirely free of risks, most reported problems with massage were associated with "exotic types of manual massage or massage delivered by laymen."

Prayer

If meditation, yoga and deep breathing may help people use their minds to heal their bodies, what of the power of faith? The NCCAM survey found that 43 percent of people pray for their own health and 24 percent have had others pray for their health in the previous year -- a total of 45 percent reported some sort of prayer for health reasons.

Prayer was by far the most common alternative treatment in the survey.

But can we measure the power of prayer? Studies have found that people who regularly attend church live longer than those who don't, but the fact that they smoke less and tend to be less depressed may account for their durability. People who have others praying for them when they are ill also tend to have the personal relationships that have proven health benefits. Is it possible to separate prayer from other factors to see whether prayer alone can affect people's health?

Duke cardiologist Mitchell Krucoff studied 750 patients undergoing heart catheterization or angioplasty. Preliminary results showed that one group of patients who were prayed for by multiple prayer groups (Roman Catholics in the United States, Buddhist monks in Nepal, Jews in Israel) did no better than a group that received standard care or a third group that received therapies including guided imagery, music, stress relaxation or touch therapy. A fourth group, which received both prayers and the relaxation therapies, however, showed a significant reduction in death rates compared with the other therapies.

"The combination of the bedside therapies and the prayer intervention creates a trend to improve survival," Krucoff said.

The study of prayer as a health intervention raises ethical questions -- as well as theological ones, such as: Do the prayers of 1,000 strangers count more than those of a mother at her sick child's bedside? -- but some researchers say prayer is worth studying.

"There is an association with spirituality, religious practice and prayer that all seem to have an impact," Baime said. "If we really believe in the scientific method, it's worth investigation. Otherwise we're just blowing hot air."•

Elizabeth R. Agnvall last wrote for the Health section about health club fitness legislation. Staff writer January Payne also contributed to this story.