Nonpharmacological Management and Use of Complementary and Alternative Medicine Therapies for Asthma

Yehudit Pollack, MD, and Christy Kim, MD

Introduction

•Use of nonpharmacological therapies for asthma, as well as complementary and alternative medicine (CAM), are increasing.

•Asthma ranked eighth among pediatric conditions, prompting the use of complementary health approaches.

•Clinicians should routinely ask patients about the use of nonpharmacological and CAM therapies.

•Conventional medical treatments are very effective in managing asthma, while the evidence for CAM for asthma is limited.

Physical Techniques

Acupuncture

•Points on the body are stimulated with needles, pressure, or lasers.

•A few studies indicate small benefits, but most show no difference in asthma symptoms or lung function between actual and simulated (“sham”) acupuncture.

•At this time, there is little evidence that acupuncture is an effective treatment for asthma.

•Potential risks include pain, burns, infectious disease transmission from improperly sterilized needles, and delay in seeking more effective care.

Breathing Exercises and/or Respiratory Retraining

•Buteyko and other breathing techniques are aimed at reducing hyperventilation through various breathing exercises.

—There is some evidence that hyperventilation reduction techniques may reduce asthma symptoms and use of reliever medication in adults, but there is insufficient evidence in children.

—Evidence is insufficient to determine whether these techniques improve asthma outcomes in children.

•Some adult studies have shown improvement in quality of life scores with respiratory retraining in asthmatic patients.

—In patients in whom emotional stress is a substantial asthma trigger, breathing exercises may have an indirect benefit as a stress-reduction strategy.

•Breathing exercises are low-risk approaches that may provide some benefit in terms of perceived well-being, but they should not replace conventional asthma medications.

Vitamins and Herbal Treatment

Herbal Treatments

•In Asia, herbal remedies have been used in traditional Chinese medicine and Ayurvedic medicine to treat asthma for centuries.