What is Complementary and Alternative Medicine?

Complementary and alternative medicine (CAM) covers a broad range of healing philosophies, approaches, and therapies. Generally , it is defined as those treatments and healthcare practices not taught widely in medical schools, not generally used in hospitals, and not usually reimbursed by medical insurance companies.

Many therapies are termed "holistic," which generally means that the healthcare practitioner considers the whole person, including physical, mental, emotional, and spiritual aspects.

Many therapies are also known as "preventive," which means that the practitioner educates and treats the person to prevent health problems from arising, rather than treating symptoms after problems have occurred. People use these treatments and therapies in a variety of ways.

Therapies are used alone (often referred to as alternative), in combination with other alternative therapies, or in addition to conventional therapies (sometimes referred to as complementary). Some approaches are consistent with physiological principles of Western medicine, while others constitute healing systems with a different origin. While some therapies are far outside the realm of accepted Western medical theory and practice, others are becoming established in mainstream medicine.

CAM covers a broad range of healing philosophies (schools of thought), approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available. A few of the many CAM practices include the use of acupuncture, herbs, homeopathy, therapeutic massage, and traditional oriental medicine to promote well-being or treat health conditions. People use CAM treatments and therapies in a variety of ways.

The list of practices that are considered CAM changes continually as CAM practices and therapies that are proven safe and effective become accepted as "mainstream" healthcare practices. Today, CAM practices may be grouped within five major domains: (1) manipulative and body-based methods, (2) alternative medical systems, (3) energy therapies, (4) biologically-based treatments and (5)mind-body interventions . The individual systems and treatments comprising these categories are too numerous to list in this document. Thus, only limited examples are provided within each.

I. MANIPULATIVE AND BODY-BASED METHODS

This category includes methods that are based on manipulation and/or movement of the body. For example, chiropractors focus on the relationship between structure (primarily the spine) and function, and how that relationship affects the preservation and restoration of health, using manipulative therapy as an integral treatment tool. Some osteopaths, who place particular emphasis on the musculoskelatal system, believing that all of the body's systems work together and that disturbances in one system may have an impact upon function elsewhere in the body, practice osteopathic manipulation. Massage therapists manipulate the soft tissues of the body to normalize those tissues.

II. ALTERNATIVE MEDICAL SYSTEMS

Alternative medical systems involve complete systems of theory and practice that have evolved independent of and often prior to the conventional biomedical approach. Many are traditional systems of medicine that are practiced by individual cultures throughout the world, including a number of venerable Asian approaches.

Traditional oriental medicine emphasizes the proper balance or disturbances of qi (pronounced chi), or vital energy, in health and disease, respectively. Traditional oriental medicine consists of a group of techniques and methods, including acupuncture, herbal medicine, oriental massage, and qi gong (a form of energy therapy described more fully below). Acupuncture involves stimulating specific anatomic points in the body for therapeutic purposes, usually by puncturing the skin with a needle.

Ayurveda is India's traditional system of medicine. Ayurvedic medicine (meaning "science of life") is a comprehensive system of medicine that places equal emphasis on body, mind, and spirit, and strives to restore the innate harmony of the individual. Some of the primary Ayurvedic treatments include diet, exercise, meditation, herbs, massage, exposure to sunlight, and controlled breathing.

Other traditional medical systems have been developed by Native American, Aboriginal, African, Middle-Eastern, Tibetan, Central and South American cultures.

Homeopathy and naturopathy are also examples of complete alternative medical systems. Homeopathy is an unconventional Western system that is based on the principle that "like cures like," i.e., that the same substance that in large doses produces the symptoms of an illness, in very minute doses cures it. Homeopathic physicians believe that the more dilute the remedy, the greater its potency. Therefore, homeopaths use small doses of specially prepared plant extracts and minerals to stimulate the body's defense mechanisms and healing processes in order to treat illness.

Naturopathy views disease as a manifestation of alterations in the processes by which the body naturally heals itself and emphasizes health restoration rather than disease treatment. Naturopathic physicians employ an array of healing practices, including diet and clinical nutrition; homeopathy; acupuncture; herbal medicine; hydrotherapy (the use of water in a range of temperatures and methods of applications); spinal and soft-tissue manipulation; physical therapies involving electric currents, ultrasound, and light therapy; therapeutic counseling; and pharmacology.

III. ENERGY THERAPIES

Energy therapies focus either on energy fields originating within the body (biofields) or those from other sources (electromagnetic fields).

Biofield therapies are intended to affect the energy fields, whose existence is not yet experimentally proven, that surround and penetrate the human body. 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. Qi gong is a component of traditional oriental medicine that combines movement, meditation, and regulation of breathing to enhance the flow of vital energy (qi) in the body, to improve blood circulation, and to enhance immune function. Reiki, the Japanese word representing Universal Life Energy, is based on the belief that by channeling spiritual energy through the practitioner the spirit is healed, and it in turn heals the physical body. Therapeutic Touch is derived from the ancient technique of "laying-on of hands" and is based on the premise that it is the healing force of the therapist that affects the patient's recovery and that healing is promoted when the body's energies are in balance. By passing their hands over the patient, these healers identify energy imbalances.

Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating current or direct current fields, to, for example, treat asthma or cancer, or manage pain and migraine headaches.

IV. BIOLOGICAL-BASED THERAPIES

This category of CAM includes natural and biologically-based practices, interventions, and products, many of which overlap with conventional medicine's use of dietary supplements. Included are herbal, special dietary, orthomolecular, and individual biological therapies.

Herbal therapies employ individual or mixtures of herbs for therapeutic value. An herb is a plant or plant part that produces and contains chemical substances that act upon the body. Special diet therapies, such as those proposed by Drs. Atkins, Ornish, Pritikin, and Weil, are believed to prevent and or control illness as well as promote health. Orthomolecular therapies aim to treat disease with varying concentrations of chemicals, such as, magnesium, melatonin, and mega-doses of vitamins. Biological therapies include, for example, the use of laetrile and shark cartilage to treat cancer and bee pollen to treat autoimmune and inflammatory diseases.

V. MIND-BODY INTERVENTIONS

Mind-body interventions employ a variety of techniques designed to facilitate the mind's capacity to affect bodily function and symptoms. Only a subset of mind-body interventions are considered CAM. Many that have a well-documented theoretical basis, for example, patient education and cognitive-behavioral approaches are now considered "mainstream." On the other hand, meditation, certain uses of hypnosis, dance, music, and art therapy, and prayer and mental healing are categorized as complementary and alternative.

For more information on terminologies used in this field, please check the glossary of alternative medicine.

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1. The term conventional medicine refers to medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees, some of whom may also practice complementary and alternative medicine. Other terms for conventional medicine are allopathy, Western, regular, and mainstream medicine, and biomedicine.

2. These are the categories within which NCCAM has chosen to group the numerous CAM practices; others employ different, broad groupings.