Outside The Box

Sometimes the Best Medicine is No Medicine

By Marie Look

According to the 2007 National Health Interview Survey (NHIS), 38 percent of American adults use some form of complementary and alternative medicine (CAM). Developments in technology and an increase in the available information have made it possible for more patients to consider incorporating alternative medicine into their treatment, including the management of pain; however, many of these practices still have a long way to go before gaining general acceptance in the United States. While the effectiveness of any treatment, even a conventional one, can never be guaranteed, many people do experience positive results with alternative treatments, and CAM should therefore not be immediately ruled out.

But what, exactly, qualifies as CAM? The National Center for Complementary and Alternative Medicine (NCCAM) determines alternative medicine to be any medical products and practices that are not part of standard care, as practiced by medical doctors, doctors of osteopathy and allied health professionals, such as registered nurses and physical therapists. Complementary medicine refers to alternative products and practices used in conjunction with conventional medicine (sometimes also called Western medicine), such as the use of acupuncture or massage to manage pain symptoms.

The categories of CAM are always changing as techniques gain more use and acceptance, but for patients’ ease of understanding, the NCCAM separates alternative practices into three major categories: natural products, such as herbal supplements and probiotics; mind and body medicine, such as meditation, yoga, acupuncture, hypnotherapy and breathing exercises; and manipulative and body-based practices, such as spinal manipulation and massage. The NCCAM does recognize other methods that lie outside those three major categories, for example, the use of energy fields, Reiki, light therapy, homeopathy, Ayurveda, biofeedback and countless other techniques.

When trying to decide whether CAM is right for you, there are several important factors to understand and consider. First, discuss the treatment’s safety and effectiveness with your physician. Since alternative medicine is not widely accepted by institutions and physicians who mainly practice conventional medicine, there are fewer corresponding clinical trials — and therefore fewer reports on their effectiveness. Regardless, a knowledgeable physician or certified pain specialist should be able to be upfront with you regarding the risks if any are known, as well as the margin of success you can expect.

Second, be selective in your choice of CAM practitioner. Learn as much as possible about the education and experience of the practitioner or the history and credentials of the institution. It can be extremely beneficial to find a specialist who understands your goals and priorities when it comes to receiving treatment.

Third, you should always keep your physician informed of any alternative treatments your are undergoing, and vice versa — be sure to also inform your alternative medicine specialist of your conventional medicines and treatments. This will help to avoid any negative interactions, among drugs and supplements.

As the gap between conventional and alternative medicines continues to narrow, the number of alternative treatments widely accepted in the U.S. will increase. According to the 2007 NHIS, 38 percent of American adults (roughly 4 in 10) use some form of CAM, which is a 2 percent increase from the 2002 NHIS, and revealing that acceptance of alternative medicine is on the rise. At the time of the 2007 survey, the top 10 CAM therapies were:

  • Natural products (17.7%)
  • Deep breathing (12.7%)
  • Meditation (9.4%)
  • Chiropractic/osteopathic (8.6%)
  • Massage (8.3%)
  • Yoga (6.1%)
  • Diet-based therapies (3.6%)
  • Progressive relaxation (2.9%)
  • Guided imagery (2.2%)
  • Homeopathic treatment (1.8%)

Out of the 10 CAM therapies most commonly used, the four types which experienced the most significant rise in popularity between 2002 and 2007 were deep breathing, meditation, massage and yoga (in that order). There are a number of diseases and conditions which may be treated with CAM, although American adults are most likely to use CAM for musculoskeletal issues such as back, neck or joint pain. Let’s take a look at what’s involved with a few of the most common therapies.

An increasingly popular CAM therapy, massage is a form of soft-tissue manipulation that can be applied to treat or relieve many chronic pain conditions, for example, muscular tension, stress or anxiety, muscle soreness, traumatic injury, labor pain, cancer pain and muscle spasms. The goal of massage therapy is to decrease overall muscle tension, which is generally accomplished by increasing function of the parasympathetic nervous system and decreasing the effects of the sympathetic nervous system.

The need for diet-based therapy, such as exercise and nutritional counseling, has also increased dramatically in recent times, as it has been shown to have both physical and emotional benefits. This type of therapy may include the gradual elimination of nicotine or caffeine use, or treatment of obesity in order to prevent its many serious medical complications. Obesity is a major problem in the U.S., particularly among seniors — 45 percent of adults over the age of 60 are obese — however, nutrition counseling has been shown to reduce body fat composition in obese adults. Regardless of the CAM you are considering, it is important to do as much research as possible, and to initiate a conversation with your physician or CAM practitioner concerning the alternative treatments that might best suit your needs and condition. Resources you should consider consulting include NCCAM, found at nccam.nih.gov, and the National Library of Medicine, found at Medlineplus.gov.