Complementary Health and Wellness

What Is Complementary and Alternative Medicine?

According to the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health,

[Complementary and Alternative Medicine (CAM)] is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. Some health care providers practice both CAM and conventional medicine. While some scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studies--questions such as whether these therapies are safe and whether they work for the diseases or medical conditions for which they are used.

The list of what is considered to be CAM changes continually, as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge.

Are complementary medicine and alternative medicine different from each other?

Yes, they are different.

• Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient's discomfort following surgery.

• Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor.

What are the major types of complementary and alternative medicine?

NCCAM groups CAM practices into four domains, recognizing there can be some overlap. In addition, NCCAM studies CAM whole medical systems, which cut across all domains.

Whole Medical Systems
Whole medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart from and earlier than the conventional medical approach used in the United States. Examples of whole medical systems that have developed in Western cultures include homeopathic medicine and naturopathic medicine. Examples of systems that have developed in non-Western cultures include traditional traditional Chinese medicine and Ayurveda.

Mind-Body Medicine
Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to affect bodily function and symptoms. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive-behavioral therapy). Other mind-body techniques are still considered CAM, including meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.

Biologically Based Practices
Biologically based practices in CAM use substances found in nature, such as herbs, foods, and vitamins. Some examples include dietary supplements, herbal products, and the use of other so-called natural but as yet scientifically unproven therapies (for example, using shark cartilage to treat cancer).

Manipulative and Body-Based Practices
Manipulative and body-based practices in CAM are based on manipulation and/or movement of one or more parts of the body. Some examples include chiropractic or osteopathic manipulation, and massage.

Energy Medicine

Energy therapies involve the use of energy fields. They are of two types:

• Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields. Examples include qi gong, Reiki, and Therapeutic Touch.

• Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating-current or direct-current fields.

Glossary

Acupuncture - The term acupuncture describes a family of procedures involving stimulation of anatomical points on the body by a variety of techniques. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries. The acupuncture technique that has been most studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.

Ayurvedic Medicine - Also called Ayurveda. It is a system of medicine that originated in India several thousand years ago. The term Ayurveda combines two Sanskrit words--ayur, which means life, and veda, which means science or knowledge. Ayurveda means "the science of life."

In the United States, Ayurveda is considered a type of CAM and a whole medical system. As with other such systems, it is based on theories of health and illness and on ways to prevent, manage, or treat health problems. Ayurveda aims to integrate and balance the body, mind, and spirit (thus, some view it as "holistic"). This balance is believed to lead to contentment and health, and to help prevent illness. However, Ayurveda also proposes treatments for specific health problems, whether they are physical or mental. A chief aim of Ayurvedic practices is to cleanse the body of substances that can cause disease, and this is believed to help reestablish harmony and balance.

Biofeedback Training - The use of electronic devices to help people learn to control body functions that are normally unconscious (such as breathing or heart rate). The intent is to promote relaxation and improve health.

Chelation Therapy - Chelation (pronounced key-LAY-shun) therapy is an investigational therapy using a man-made amino acid, called EDTA. It is added to the blood through a vein. An international research study is now testing whether chelation therapy is safe and effective for treating heart disease.

Chiropractic - Chiropractic ("kye-roh-PRAC-tic") is a form of health care that focuses on the relationship between the body's structure, primarily of the spine, and function. Doctors of chiropractic, who are also called chiropractors or chiropractic physicians, use a type of hands-on therapy called manipulation (the application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health), or adjustment as their core clinical procedure.

• Chiropractic is most often used to treat musculoskeletal conditions--problems with the muscles, joints, bones, and connective tissue such as cartilage, ligaments, and tendons.

• Research studies of chiropractic treatment for low-back pain have been of uneven quality and insufficient to allow firm conclusions. Nonetheless, the overall sense of the data is that for low-back pain, chiropractic treatment and conventional medical treatments are about equally helpful. It is harder to draw conclusions about the relative value of chiropractic for other clinical conditions.

• The risk of experiencing complications from chiropractic adjustment of the low back appears to be very low. However, the risk appears to be higher for adjustment of the neck.

Herbal Medicine - Herbs are plants or parts of plants used for their flavor, scent, or potential therapeutic properties. For more information on the properties of specific plants, see "Herbs at a Glance," http://nccam.nih.gov/health/herbsataglance.htm.

Homeopathy - The term homeopathy comes from the Greek words homeo, meaning similar, and pathos, meaning suffering or disease. Homeopathy is an alternative medical system. Alternative medical systems are built upon complete systems of theory and practice, and often have evolved apart from and earlier than the conventional medical approach used in the United States. Homeopathy takes a different approach from conventional medicine in diagnosing, classifying, and treating medical problems.

Key concepts of homeopathy include:

• Homeopathy seeks to stimulate the body's defense mechanisms and processes so as to prevent or treat illness.

• Treatment involves giving very small doses of substances called remedies that, according to homeopathy, would produce the same or similar symptoms of illness in healthy people if they were given in larger doses.

• Treatment in homeopathy is individualized (tailored to each person). Homeopathic practitioners select remedies according to a total picture of the patient, including not only symptoms but lifestyle, emotional and mental states, and other factors.

Because of their long use in the United States, the U.S. Congress passed a law in 1938 declaring that homeopathic remedies are to be regulated by the FDA in the same manner as nonprescription, over-the-counter (OTC) drugs, which means that they can be purchased without a physician's prescription. Today, although conventional prescription drugs and new OTC drugs must undergo thorough testing and review by the FDA for safety and effectiveness before they can be sold, this requirement does not apply to homeopathic remedies.

Here is some general information that has been reported about risks and side effects in homeopathy:

• Homeopathic medicines in high dilutions, taken under the supervision of trained professionals, are considered safe and unlikely to cause severe adverse reactions.

• Some patients report feeling worse for a brief period of time after starting homeopathic remedies. Homeopaths interpret this as the body temporarily stimulating symptoms while it makes an effort to restore health.

• Liquid homeopathic remedies can contain alcohol and are permitted to have higher levels of alcohol than conventional drugs for adults. This may be of concern to some consumers. However, no adverse effects from the alcohol levels have been reported either to the FDA or in the scientific literature.

• Homeopathic remedies are not known to interfere with conventional drugs; however, if you are considering using homeopathic remedies, you should discuss this with your health care provider. If you have more than one provider, discuss it with each one.

As with all medicinal products, a person taking a homeopathic remedy is best advised to:

• Contact his health care provider if his symptoms continue unimproved for more than 5 days.

• Keep the remedy out of the reach of children.

• Consult a health care provider before using the product if the user is a woman who is pregnant or nursing a baby.

Naturopathic Medicine - Naturopathy is a system of healing, originating from Europe, that views disease as a manifestation of alterations in the processes by which the body naturally heals itself. It emphasizes health restoration as well as disease treatment. The term "naturopathy" literally translates as "nature disease." Today naturopathy is practiced throughout Europe, Australia, New Zealand, Canada, and the United States.

There are six principles that form the basis of naturopathic practice in North America (not all are unique to naturopathy):

1. The healing power of nature
2. Identification and treatment of the cause of disease
3. The concept of "first do no harm"
4. The doctor as teacher
5. Treatment of the whole person
6. Prevention

The core modalities supporting these principles include diet modification and nutritional supplements, herbal medicine, acupuncture and Chinese medicine, hydrotherapy, massage and joint manipulation, and lifestyle counseling. Treatment protocols combine what the practitioner deems to be the most suitable therapies for the individual patient.

As of this writing, virtually no research studies on naturopathy as a complete system of medicine have been published.

Nutritional or Dietary Supplements - A product that contains vitamins, minerals, herbs, or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs.

• It is intended to be taken in tablet, capsule, powder, softgel, gelcap, or liquid form.

• It is not represented for use as a conventional food or as a sole item of a meal or the diet.

• It is labeled as being a dietary supplement.

Putative Energy Medicine - putative energy fields (also called biofields) have defied measurement to date by reproducible methods. Therapies involving putative energy fields are based on the concept that human beings are infused with a subtle form of energy. This vital energy or life force is known under different names in different cultures, such as qi in traditional Chinese medicine. (TCM), ki in the Japanese Kampo system, doshas in Ayurvedic medicine. Vital energy is believed to flow throughout the material human body, but it has not been unequivocally measured by means of conventional instrumentation. Nonetheless, therapists claim that they can work with this subtle energy, see it with their own eyes, and use it to effect changes in the physical body and influence health.

Examples of practices involving putative energy fields include:

• Reiki and Johrei, both of Japanese origin

• Qi gong, a Chinese practice

• Healing touch, in which the therapist is purported to identify imbalances and correct a client's energy by passing his or her hands over the patient

• Intercessory prayer, in which a person intercedes through prayer on behalf of another

Traditional Chinese Medicine - A whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalances in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi.

Yoga - A practice from Ayurvedic medicine that combines breathing exercises, physical postures, and meditation. It is intended to calm the nervous system and balance the body, mind, and spirit.