When mainstream medicine fails to produce the desired results, people often look for alternatives. Someone with diabetes may take bitter melon or cinnamon in addition to the prescribed pharmaceuticals. A depressed person may augment antidepressants with aromatherapy massage, yoga, or reiki. Such additions to the doctor's treatment plan are examples of complementary medicine.
Over half of American patients have tried, or are trying, some form of complementary and alternative medicine (CAM). Many of these patients will never mention their use of CAM to their doctors, for fear of a negative reaction. This reluctance to communicate can have unfortunate results if the doctor's treatment plan and the patient's complementary regimen are working at cross-purposes instead of synergistically. Fortunately, medical schools are beginning to include CAM in their curricula. Some universities have departments of integrative medicine, which seek to wed conventional mainstream medical treatment with complementary therapies.
Ancient healing systems such as Ayurveda, naturopathy, or Chi Gong existed long before the birth of modern Western medicine. Rather than focusing on clinical symptoms, they address the whole person and his or her lifestyle, spirituality and culture. Many different practices, both physical and spiritual, center on a coherent philosophy of life which holds everything together.
For those who are not willing to have their whole life remodelled, specific therapies are offered by a variety of practitioners. Mind-body connection techniques include meditation, yoga, biofeedback, prayer, hypnosis, relaxation training and art therapy. These are intended to promote harmony and communication between the mind and body.
Dietary supplements and herbal remedies can be found in specialty stores as well as in mainline pharmacies. Touch and manipulation therapies include chiropracty, massage, craniosacral therapy, and acupressure. Energy therapies such as therapeutic touch, Reiki, magnet and light therapy seek to unblock and balance the energy forces in the body.
The more invasive the treatment, the more important it is to be well-informed and seek a competent practitioner. Improperly performed therapeutic touch (which does not actually involve touching the patient) may still have a positive effect if the person performing it shows friendly concern for the patient. On the other hand, an inept chiropractic manipulation could cause permanent damage.
Do complementary therapies work, or are they a waste of time, effort and money? Strong voices can be heard on both sides. Randomized controlled clinical trials (RTCs), the gold standard for mainstream medicine, are very expensive, and unlikely to be conducted unless they promise to serve the purposes of those who are underwriting the cost. RTCs examine a limited number of variables under optimal conditions, and their results are not necessarily reflected in the perceptions of patients. In a 2003 study of patient reports, 60% considered their asthma medication effective, and only 52% of migraine sufferers were satisfied with the performance of their pharmaceuticals.
The effectiveness of both mainstream and complementary medical treatment is determined by factors other than clinical performance. The beliefs of the patients have great influence. Patients in Taiwan and Japan report a much higher success rate for acupuncture than North American patients do.
The relationship between healer and patient is also a vital ingredient to healing. Since practitioners of CAM typically spend more focused time with their patients than mainstream doctors, they are more likely to build a relationship of trust and confidence whose benefits may be more therapeutic than the treatment itself. Lifestyle issues are often addressed as well as the presenting problem, improving the patient's quality of life even if the initial complaint remains the same. When healing is seen as a developmental process that unfolds over a lifetime, standard clinical evaluations have only limited usefulness.
With some common-sense precautions, complementary medicine has the potential to not only relieve a particular medical problem, but also infuse new life and hope. In time, all medicine may become multi-disciplinary and integrative, drawing the best from a variety of approaches with the goal of healing the whole person instead of merely treating symptoms.
Sources and resources:
http://www.mayoclinic.com/health/alternative-medicin e/PN00001
A comprehensive overview, with multiple links to related topics.
http://pim.med.unc.edu/Effectiveness.pdf
"Assessing the Effectiveness of Complementary and Alternative Medicine" published by the Department of Integrative Medicine, University of North Carolina, for health care professionals. Lengthy and technical, but addresses important issues.