Complementary and Alternative Therapies for Sickle Cell

People with sickle cell disease (SCD) have misshapen red blood cells that stick inside blood vessels. This leads to sickle cell crises that cause intense pain. These are sometimes called acute pain crises or vaso-occlusive crises. Opioids are commonly used to manage this pain.^1-3

However, many people with SCD try complementary and alternative medicine (CAM) to control pain. CAM treatments differ from traditional medical treatments because they are not based in science. They do not replace traditional medical treatments but may provide additional pain relief.^1-3

CAM and sickle cell

SCD-related pain can be disabling and affect your work and social life. It can also lead to depression. SCD pain is unpredictable and intense. Doctors can give opioids to manage pain, but many people look for other ways to manage pain. As many as 9 out of every 10 people with SCD try some form of complementary and alternative medicine for pain control.^1-4

Types of complementary and alternative medicine

CAM can be loosely sorted into several categories. Descriptions and some examples of each include:⁵

• Vitamins, herbs, and supplements
• Deep breathing, hypnosis, meditation
• Acupuncture
• Dance and art therapy
• Spirituality and prayer
• Meditation and yoga
• Chiropractic care
• Tai chi and reiki
• Massage
• Lifestyle diets

Prayer, naturopathy, and massage are the most common CAM approaches. These are usually passed down from family and friends. CAM usage is linked to certain cultures and religions. Using complementary and alternative medicine is more common in developing countries compared to the United States.⁴

Benefits of complementary and alternative medicine

CAM may be appealing to those wanting a holistic approach to health. Most studies show CAM as helpful in managing pain, depression, and anxiety in those with SCD. People using CAM report less pain and fewer side effects than opioids.^4,7

Religion is a CAM approach many with SCD find helpful. It may play a role in controlling pain, as prayer and regularly attending church lessen perceived pain. People report relaxation and exercise also lessen pain.^6-8

For SCD-related avascular necrosis, massage may lower opioid usage and hospital trips. Avascular necrosis results from temporary or permanent loss of blood supply to bone in the hip or shoulder joint. This loss of blood causes narrowing of the joint and collapse of the bone.^6-8

Is there a downside to complementary and alternative medicine?

Alternative medicines are not regulated by the U.S. Food and Drug Administration (FDA). These medicines may not be pure and/or dosages can be variable. Though marketed as “natural,” these medicines may interact with your other drugs and cause a reaction. They can also cause the other drugs you take to work differently. This could make your SCD and other health conditions worse.

Some CAM may require trained specialists that may be hard to find. Insurance plans may not cover CAM therapies either. This may raise out-of-pocket costs for people using them. Also, CAM may not work for you. This can be disappointing for those needing pain relief.

Complementary and alternative medicine and caregivers

CAM may be more work for caretakers of kids with SCD. For example, nightly massage is linked to less anxiety and depression in kids with SCD. The kids also have higher functional scores. However, caregivers have higher stress levels and cite the stress of doing CAM before bedtime as the reason.⁹

Is complementary and alternative medicine an option for you?

CAM approaches may help control pain and lower anxiety and depression. Certain CAM approaches teach coping skills for chronic pain. Since living with chronic pain raises the risk of depression and anxiety by 4 times, CAM coping skills may raise your quality of life.^2,5

If you are interested in complementary and alternative medicine, talk to your doctor. CAM therapies combined with your existing SCD treatment may provide additional pain relief.^3,5