Monday, June 16, 2008

Complementary and alternative medicine

You probably have a basic understanding of how modern medicine works: People have a yearly checkup, take an antibiotic when they're sick, get a cast for a broken arm, and they're good as new.

But in recent years other approaches to healing have risen in popularity. Many of these "alternative" techniques come from all over the globe and have been around for thousands of years. So what is alternative medicine and what does it do?

What Is It?

The term "alternative medicine" is used to describe healing treatments that are not part of conventional medical training — like acupuncture, massage therapy, or herbal medicine. People used to consider practices like these outside the mainstream, which is why they got the name "alternative."

Eastern countries have a longstanding tradition of teaching alternative medicine. But until recently, most Western hospitals didn't provide any alternative treatments and Western medical schools didn't teach them.

Patients in Western countries are becoming more receptive to trying alternative techniques, and have been asking for them. As a result, many Western medical schools are starting to teach these medicine techniques and theories. Some hospitals and doctors are supplementing their regular medical care with alternative techniques.

Many patients and health care providers use alternative treatments together with conventional therapies. This is known as complementary medicine.

Both alternative and complementary medicine use the same kinds of remedies to treat a health condition. The difference is that alternative medicine is often used instead of conventional medical techniques. Complementary medicine is used in addition to conventional medicine, not as a replacement. The field of complementary and alternative medicine is known as CAM for short.

How Is CAM Different From Conventional Medicine?

Conventional medicine (also called "allopathic medicine") is based on scientific knowledge of the body and uses treatments that have been proven effective through scientific research. Doctors are trained to have a thorough knowledge of the body's systems, diseases, and their treatments.

Complementary and alternative medicine is based on the belief that a medical care provider has to treat the whole person — body, mind, and spirit. The techniques used in CAM are mostly less invasive than conventional medical practices — meaning that they don't rely on surgery or conventional medications.

Some CAM therapies are supported by scientific evidence. But for most there are still questions that need to be addressed through scientific studies. This doesn't mean these therapies don't work, it just means that experts haven't studied them enough to know for sure that they do — and if so, how.

Why Do People Use CAM?

People often turn to CAM when they have a long-lasting problem that conventional medicine hasn't completely cured. For example, someone who has seen a doctor for years about persistent headaches might try using CAM in addition to current treatments to deal with any symptoms or side effects from conventional treatments.

People may also use complementary and alternative medicine when they're not sick. Because many people believe that CAM techniques — such as yoga — can improve overall well being, healthy people often use alternative medicine to try to prevent illness or to ensure a healthier lifestyle.


Just as there are many fields in conventional medicine, CAM covers many different practices. The National Center for Complementary and Alternative Medicine (NCCAM), which is part of the National Institutes of Health (NIH), groups CAM practices into four areas:

  1. Biologically based practices involve supplementing a person's normal diet with additional nutrients, herbs, extracts, and certain foods. If you've ever taken a vitamin or herbal supplement, you've followed a biologically based practice.
  2. Manipulative and body-based therapies focus on the body's various systems and structures. If you've ever seen a chiropractor or had a massage, you've been treated with manipulative therapy.
  3. Mind-body interventions use the connection between a person's mind, body, and spirit to enhance total well being. Mind-body techniques include meditation, yoga, and biofeedback.
  4. Energy therapies are meant to restore disturbances in the body's natural energy. Energy therapies include such practices as Qi gong and Reiki.

In addition to these four different practices, CAM includes several whole medical systems. These alternative medical systems are entire systems of theory and practice, and many date back earlier than the conventional medicine we use in the West today. Examples of alternative medical systems include Traditional Chinese Medicine, Ayurveda, homeopathic medicine, and naturopathic medicine.

Alternative medical systems incorporate many of the different practices listed above into their treatments. For example, the Traditional Chinese Medicine practice of acupuncture may be combined with herbal medicine (a biologically based practice), and Qi gong (an energy therapy). And Ayurveda includes the mind-body therapies of meditation and yoga, along with the biologically based practice of taking specific herbs for health reasons.

Some CAM practices are supported by scientific research, while others have not yet been studied. Sometimes experts have scientific evidence that a CAM practice (like acupuncture) works, but they don't have a clear understanding of why.


Although CAM does have some proven benefits, like anything, it has its limitations.

Experts haven't researched many CAM techniques enough to tell how effective they are as treatments. Some people may not feel it's worth investing a lot of time or money in treatments that haven't been proven effective. Insurance policies rarely cover CAM treatments, so people have to pay for them out of their own pockets with no reimbursement.

For some health problems, alternative healing approaches on their own may not be enough to help a person get well. Even something as seemingly minor as an infection may need treatment with traditional medications, like antibiotics. That's why it's always best to see your doctor if you have a health problem and talk openly about any CAM techniques you might want to try.

Another reason you should be up-front with your doctor about CAM techniques is because, in some cases, CAM practices can actually interfere with traditional medical treatments. For example, certain herbal supplements can interfere with some prescription drugs, such as diabetes treatments or birth-control pills.

As with modern medicine, CAM treatments that are effective for one problem will not help with all problems. For example, acupuncture has been proven to help reduce migraines for people under 18 years old, but is controversial as to whether is helps in other situations. Certain treatments are only used for certain problems, so if you want to try an alternative practice for a health reason, make sure it will help the specific problem you're looking to correct.

Before You Try It

Traditional medical doctors are not only trained, they're licensed. But that's not always the case with CAM practitioners. Some states have licensing requirements for certain specialists, like acupuncturists and massage therapists, and many are expanding their requirements for licensing as CAM practices grow in popularity.

Finding a good CAM practitioner is still not as easy as looking someone up in a phone book. NCCAM recommends asking another health care provider for a referral, talking to people who have been treated by the expert you are considering, and meeting with the practitioner to ask about his or her experience and training — the same kinds of things you'd do if you were interviewing a new doctor.

You may have already used a complementary or alternative practice, like yoga or massage, and not even thought about it! Trying practices like meditation and breathing can't do any harm, but other CAM techniques may have consequences for people with certain health conditions. Even the more mainstream practices like yoga can hurt someone with a health condition — like a back problem — if they are not done properly. So check with your doctor before trying any CAM techniques. Your doctor will try to guide you on which practices you can safely try while continuing with your current method of treatment.

Reviewed by: Larissa Hirsch, MD
Date reviewed: January 2007

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