Description

• Complementary and alternative medicine (CAM) are medical and health care systems, practices, and products that are not currently considered as part of conventional Western medicine and can be used in conjunction with conventional medicine.
• Alternative medicine is used in place of conventional medicine to promote healing of conditions not fully explained by the conventional biomedical model or for which the effectiveness of therapy is not yet established by clinical research.
• Integrative medicine is the combination of allopathic and/or osteopathic medicine with CAM and may be provided to the patient by a single licensed medical professional trained in CAM or by a group of diverse health care providers.
• Holistic is a descriptive term for a practitioner’s approach to patient care that assesses the emotional, spiritual, mental, and physical state of wellness of the patient and works to provide comprehensive care.
• Manipulative and body-based methods include:
  • Massage therapy is manipulation of soft tissues using knowledge of anatomy and physiology to restore function, promote relaxation, and relieve pain.
  • Tenets of osteopathic manipulative treatment (OMT) from American Osteopathic Association:
    • Rational treatment is based on an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function; structure and function are reciprocally interrelated; the body is capable of self-regulation, self-healing, and health maintenance; the body is a unit; the person is a unit of body, mind, and spirit.
  • Chiropractic therapy focuses on imbalances in the musculoskeletal and nervous system to treat back, neck, and joint pain.
  • Cupping uses pressure suction to help improve blood flow to skin, decrease pain, and reduce inflammation.
• Mind–body medicine include:
  • Meditation is a practice of detachment in which a person sits quietly, generally focusing on the breath, while releasing thoughts from the mind with the intention to center self, restore balance, and enhance well-being.
  • Yoga is an exercise of mindfulness, meditation, strength, and balance, composed of asanas (postures) and pranayamas (focused breathing).
  • Aromatherapy uses highly concentrated plant extracts to stimulate healing.
• Alternative medical systems include:
  • Traditional Chinese medicine (TCM) incorporates Chinese herbs and acupuncture. Acupuncture is the practice of regulating chi by inserting thin needles at specific points along meridian pathways of the body.
  • Ayurvedic medicine originated in India and uses healing modalities and herbs to integrate and balance the body, mind, and spirit.
  • Homeopathy proposes that dilute quantities of an offending agent can stimulate innate immunity.
  • Naturopathy includes herbs, vitamins, supplements, dietary counseling, homeopathic remedies, manipulative therapies, acupuncture, and hydrotherapy.
• Energy therapies
  • Reiki, “source energy,” involves laying hands lightly on patient or holding the hands just above the body and facilitates spiritual and physical healing by stimulating life force energy.
• Common reasons patients choose CAM
  • Additive therapy to address issues not covered by conventional medical treatment
  • Conventional medicine has been unsuccessful in fully addressing ailment.
  • Preventative health care and/or a desire for a more holistic/natural/noninvasive approach to well-being
  • Concern about medication side effects
  • Cultural or familial belief system more aligned with “natural” solutions

Epidemiology

All ages use CAM; most common use is among 30 to 69 year old females. More prevalent use of CAM among adults with higher levels of education, high socioeconomic status, living in West, former tobacco use disorder, and/or recently hospitalized. Cancer survivors are more likely to use CAM (1).

Prevalence
CAM is most frequently used to treat musculoskeletal issues; 59–90% of patients claim that use of alternative therapy helped their chronic pain (1).

General Prevention

Many core principles of CAM therapy are used for general prevention of chronic disease.

Commonly Associated Conditions

Acute/chronic pain; osteoarthritis; fibromyalgia; poor quality sleep; fatigue; symptoms from cancer diagnosis and side effects from treatment; headache/migraine; irritable bowel syndrome (IBS); depression/anxiety; low libido; weight loss; asthma; eczema; tinnitus; autoimmune disease