Complementary and Alternative Medicine

Instead of depending on physicians, millions of people choose alternative therapies such as acupuncture, naturopathy, or massage. Some of these therapies have ancient origins that date back thousands of years; others are relatively new developments. Unlike treatments used in conventional medicine, which take a biological and scientific approach to illness, these methods use a "holistic" approach—incorporating a patient's lifestyle, habits, and personality into the diagnostic and therapeutic process. Treatments rarely require drugs; instead, these unconventional therapies may rely on manual manipulations, herbal remedies, or dietary changes. Many practitioners refer to the therapies as "complementary" rather than "alternative"; they believe these approaches should be used to complement rather than replace conventional therapies.

For years, the U.S. medical community dismissed alternative medicine as fraudulent, largely because little scientific evidence supported its merit. But late in the 20th century, a growing body of research indicated that at least some of the therapies were effective. As a result, many U.S. doctors and medical institutions began to consider these methods as valid, and alternative therapies gradually made their way into mainstream health care.

In 1992, the Office of Alternative Medicine (OAM) was established within the National Institutes of Health (NIH) to evaluate alternative medical techniques. Legislation enacted in 1998 expanded OAM into the National Center for Complementary and Alternative Medicine (NCCAM). A substantial increase in the center's budget during its initial years of operation gives testimony to the role alternative approaches now play in the U.S. health-care system. Hospitals throughout the United States have opened special centers that mix alternative medicine with traditional methods, and health-insurance companies now reimburse for the cost of some of these therapies.


This ancient healing method originated in China more than 2,000 years ago. Acupuncture is based on the idea of an invisible energy, or life force, that circulates within the body. Known as chi, this force keeps the body functioning in a balanced, healthy state. Illness represents an excess or deficiency in the flow of this energy. By inserting small, thin needles into a variety of specific meridians, or points, along the body, acupuncturists restore chi to its proper state and stimulate the immune system into action. Sometimes herbal medicines or moxibustion, a form of heat therapy, are also part of the treatment.

Acupuncturists believe emotions and physical reactions are inextricably linked. As a result, since each person is unique, there are no standard prescriptions for treating a problem. Acupuncture is often used to treat muscle pain, respiratory problems, gastrointestinal disorders, and addictions such as smoking.

Acupuncture has been effective in relieving the nausea that often follows anesthesia or chemotherapy, morning sickness during pregnancy, recurrent headaches, and pain following dental procedures. There is also evidence that acupuncture helps to ease muscle pains and cramps. Some authorities believe that acupuncture points may be acted upon to stimulate the nervous system and prompt the release of endorphins (the body's natural painkillers) and hormones (which may influence the body's self-regulating systems). It is generally believed that acupuncture works best when combined with—not substituted for—conventional therapy. Insurance companies are beginning to cover more of its cost.

Problems such as cancer, infectious diseases, and emergency situations are probably better treated with orthodox medicine, though acupuncture can be used as a complementary procedure for pain.


Biofeedback therapy is a behavioral treatment using scientific instruments to measure and "feed back" information about such biological functions as heart rate, muscle tension, and skin activity. It is designed to teach people to control certain physiological responses, and thereby to reduce or eliminate a health problem.

As in other unconventional practices, the relationship between the body and mind is the underlying principle of biofeedback training. Certain emotional states, such as stress or fear, can produce such bodily responses as tension headaches or high blood pressure. With the help of electrodes placed on the body and attached to machines that give visual or auditory readings, a person becomes aware of his or her physiological responses and is gradually taught how to control them. The most common biofeedback procedure measures muscle tension with an electromyograph (EMG), and helps relieve tension headaches, insomnia, and anxiety. Other conditions that are helped by biofeedback applications include epilepsy, chronic pain, and motion sickness. Currently, studies are exploring the use of this method for weight control, smoking cessation, and drug-abuse therapy.


In 1895, Daniel David Palmer experimented on a deaf patient by manipulating a painful vertebra in the patient's upper spine. The patient had reported losing his hearing at the same time his back problem developed. After several sessions of manipulation, the patient could hear. This phenomenon led to Palmer's hypothesis that the spine and nervous system play a significant role in the proper functioning of the human body. Thousands of years earlier, Hippocrates had also written about the relationship between the spine and disease.

Today, doctors of chiropractic follow the theory that subluxations, or dysfunctions, in any of the 24 vertebrae of the spine disturb the body's equilibrium and cause headaches, back pain, and other problems. Chiropractic is now the third-largest primary-health-care profession after medicine and dentistry. While, years ago, people chose this method as a last resort, patients are increasingly seeking chiropractic care before visiting a conventional medical doctor. The proportion of the U.S. population that uses chiropractic and the number of chiropractic visits per capita have approximately doubled in the past 20 years. Today, more than 30 million people visit chiropractors each year. Treatment is characterized by manipulations of the spine and related joints to normalize their functions and return the body to a homeostatic state. Electromuscular stimulation, ultrasound heat, or cold compresses may be part of the therapy.

Chiropractic is more accepted by the medical community (at least as a pain treatment) than are most other alternative-medicine practices. Studies have shown that chiropractic has positive effects on women who suffer from menstrual pain; other studies have shown that for tension headaches, spinal adjustments are just as effective as the use of drugs and medications.


The use of natural medicines made from minute doses of plant, mineral, or animal substances is the core of homeopathic healing. This system, developed several hundred years ago, is part of mainstream medicine in Europe today. Some 3,000 American health professionals now practice this therapy, and its comeback is said to be largely due to the growing concern over the often troublesome side effects of contemporary drugs and medications.

Homeopathy attempts to stimulate the body into healing itself. Proponents believe that a symptom is the body's way of correcting an ailment. It operates under the principle of "like cures like"—meaning that an illness can be treated with a very diluted amount of the same substance that causes the illness in a healthy person. Some conventional treatments, such as vaccines, are loosely constructed around this same theory. For example, rather than suppressing a fever with medicine, a homeopath would use a remedy that induces fever, and thus speeds the body's own healing process. Though homeopathy ostensibly believes no two patients are alike, there are standard remedies for common health problems available in pharmacies and regulated by the Food and Drug Administration (FDA). Homeopathy is used to treat a wide variety of conditions, including infections, arthritis, allergies, chronic pain, and gastrointestinal disorders. But most homeopaths concede that more-serious and incurable diseases should not be treated with these remedies.

German physician Samuel Hahnemann is credited with the development of homeopathic medicine. By the mid-1800s, homeopathy was one of the leading forms of medicine practiced in Europe and the United States, and was more successful at treating cholera, typhoid, and other infectious diseases than any other medical-treatment options available at that time. In fact, the American Institute of Homeopathy was this country's first medical association, predating the American Medical Association (AMA) by three years. Yet subsequent advances in medical technology and antibiotics led to a decline in homeopathy.

Homeopathy has met with extensive criticism among practitioners of conventional medicine, particularly because of the paradox that the more diluted a substance, the better it works. Yet recent studies have suggested that homeopathic remedies are effective in treating the temporary symptoms of minor diseases.


This approach to health and healing relies on the restorative powers of nature. Like homeopathy, naturopathy views symptoms as an indication that the body is trying to heal itself—not as the actual illness. The role of the naturopathic physician is to look at the root causes of the ailment, and focus on diet and lifestyle habits. The ultimate goal of naturopathic medicine is prevention, which is often accomplished by building the body's health. Proper nutrition is a cornerstone of this practice, and many conditions are treated by dietary changes and the introduction of vitamin supplements. Often naturopaths incorporate other therapies, such as acupuncture, into the healing process.

Nature-based healing dates at least as far back as the ancient Egyptians, who passed down herbal remedies, hydrotherapy (water cures), and other techniques to the Greeks. The organized practice of naturopathy in the United States began more than 100 years ago. It was quite popular in the early 1900s, until technological medicine came into favor.

Naturopathic medicine can be used to treat digestive disorders, flu, liver problems, and other ailments. The effectiveness of this method often depends on a patient's willingness to make the recommended lifestyle and dietary changes.

Massage Therapy

The use of touch to heal and soothe probably extends back to prehistoric times. It has been a valued tradition and an important part of health care (both preventative and rehabilitative) in much of the world, and has recently gained considerable respect in the United States.

Massage therapy involves the kneading and stroking of a person's skin, muscles, tendons, and ligaments. Once thought to be simply a "feel-good" indulgence, massage therapy is now recognized as having therapeutic qualities. During a massage, muscles relax, circulation increases, and endorphins—the body's natural painkillers—are released. Massage also helps speed the passage of waste products, which can contribute to soreness, and brings more oxygen and nutrients to the muscles. It is beneficial in relieving stress-related symptoms, back and other musculoskeletal pain, and in maintaining overall health. Many people also find added psychological benefits from being touched.

Massage has been particularly touted by the sports-medicine field. It is useful for warming up muscles, preventing injury, and increasing an athlete's performance. Post-event massage prevents stiffness and can be used for injury rehabilitation. This type of massage differs slightly from general massage in that it focuses on specific muscles and is usually quite vigorous.

Massage is not recommended for people with cardiac problems, certain skin and circulatory conditions, some types of cancer, and recent fractures or sprains.

Energy Medicine

Though often considered a single category, "energy medicine" contains two very different forms of treatment. Putative energy therapy refers to the thousands-of-years-old practice of manipulating the energy field that is believed to encompass the body. Veritable energy treatments rely on energy sources outside of the body—such as sound and light—to treat certain illnesses.

Though putative methods have a long history, there have been little data that show their effectiveness. The best-known and most-studied of these practices is acupuncture (discussed above). Others include Qi gong (a Chinese system that combines movement, meditation, and breathing exercises), and the Japanese forms of healing touch known as Reiki and Johrei.

In contrast, many veritable energy techniques have been shown to be effective and repeatable in multiple studies. Sound energy treatment relies on music and other noise that resonates with the frequencies of the body's organs. Its effectiveness in affecting blood pressure was documented as early as the late 1920s, and it has also been used to combat pain. Light therapy uses artificial or natural light to combat mood problems, such as seasonal affective disorder. Magnetic therapy, which has not been proven effective, employs static magnets to stimulate the microvessels of skeletal muscle, an approach designed to relieve pain.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

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