Medical practices that are not routinely included in American medical school curriculums or used in conventional medical settings are often called complementary or alternative medicine, or simply “CAM”. Many different kinds of therapies are included under the CAM “umbrella”, including acupuncture, chiropractic care, relaxation techniques, massage therapy, and herbal remedies. The term complementary medicine specifically refers to practices that are used in conjunction with conventional medicine, while alternative medicine refers to practices that are used in place of conventional medicine.
Types of CAM
Most CAM practices fall roughly into one or more of three broad categories: natural products, mind and body medicine, and manipulative and body-based practices.
Natural Products
Within CAM, the category of “natural products” includes a range of herbal medicines (also called “botanicals” or “botanical dietary supplements” or “phytomedicines”), vitamins, and minerals. Many these are sold as “over the counter” remedies. Also included in this natural products category are probiotics. Probiotics are live microorganisms (usually bacteria) that are similar to microorganisms that are normally found in the human digestive tract and that may provide some benefit to their human “hosts”. Probiotics are available in foods (like some yogurts) or as dietary supplements.
Natural products are intended to be ingested and are sold in many ways: as fresh or dried products; liquid or solid extracts; tablets, capsules, powders; tea bags; and other forms. For example, fresh ginger root is often found in the produce section of food stores; dried ginger root is sold packaged in tea bags, capsules, or tablets; and liquid preparations made from ginger root are also sold as natural beverages. In addition, a particular group of chemicals or a single chemical may be isolated from a botanical and sold as a dietary supplement, usually in tablet or capsule form. An example of this is phytoestrogens derived from soy products.
It is important to remember that just because a product is labeled “natural” doesn’t mean it is nutritious or healthy. Nor is it necessarily safe for consumption in any form and in any amount. For example, cinnamon is a natural product that has been shown in some research to beneficially reduce blood sugar levels in some people living with diabetes. It may also reduce inflammation, have antioxidant effects, and fight bacteria. This is all good. Cinnamon is derived from a kind of tree bark. So it is “natural”. But not all tree bark is safe to eat. What makes any botanical safe to ingest depends on many factors, like its chemical composition, how it works in the body, how it is prepared, and the dose used.
It is often difficult to figure out dosage with a natural product because amounts of active ingredients vary depending on how it is prepared, and can even vary from batch to batch. Even though all may use the same herbal ingredient, a cup of tea could easily have less of a botanical component than a few teaspoons of a tincture, or an even smaller quantity of an extract. Peppermint tea, for example, is generally safe to drink, but peppermint oil is much more concentrated and can be dangerous if used incorrectly.
Aside from the dangers just mentioned about potency and form, herbal remedies can have dangerous side effects, even when taken on their own. Natural products can also interact with prescription or over-the-counter medications or other dietary supplements you might be taking. Natural products might increase or decrease the action of other substances, or create an entirely different and dangerous effect when consumed at the same time as other drugs or supplements. For example, research has shown that St. John’s Wort may interact with birth control pills, causing the contraception to be ineffective.
Aromatherapy is another kind of CAM natural product that is meant to be inhaled or applied to the skin rather than ingested. Aromatherapy is the therapeutic use of essential oil from herbs, flowers, and other botanicals. However, research has not yet shown aromatherapy to be effective for anything other than general relaxation and stress reduction.
Mind and Body Medicine
Mind and body practices are another category of CAM. They harness the ability of mind and body to improve physical functioning and promote overall health.
One form of mind and body medicine is meditation techniques, including specific postures, focused attention, or an open attitude toward distractions. People use meditation to increase calmness and relaxation, improve psychological balance, cope with illness, or enhance overall health and well being. Sometimes there is a spiritual or religious component to meditative practices, but not always.
Research has actually shown that practicing meditation can positively affect the body by encouraging relaxation and reducing stress responses.
When someone is stressed or anxious, the body releases hormones that create a specific heightened physiological response. That is, the heart and breathing rates increase, blood vessels can narrow and blood pressure goes up as the cardiovascular system kicks into “fight or flight” mode. All of these things are the body’s way of preparing to face a perceived danger through combat or a VERY swift running retreat. In today’s world, however, stress is more likely to result from a looming paperwork deadline at work rather than a hungry lion staring you down from within ten feet. So the “fight or flight” response is neither productive nor, over time, good for your body. Chronic stress can overwork your immune system and thereby lower your body’s ability to fight disease, can lead to chronic high blood pressure, and other long-term, stress-related symptoms like headaches and gastrointestinal distress. Stress over a long period of time can also make existing conditions worse, like asthma and heart disease. It has also been associated with higher rates of depression, anxiety, and other mental illnesses.
When certain relaxation techniques are used, the body responds with the opposite reaction to stress. Blood pressure lowers, muscles (including those of the cardiovascular system) relax, breathing slows, and stress hormones in the bloodstream lessen. Research has indicated that when used over time, relaxation techniques might actually be able to counteract the negative effects of stress on the body. More specifically, relaxation techniques may be an effective component of a larger treatment plan for some disorders, including anxiety, depression, and certain kinds of pain, like headaches. And to make good news even better, relaxation techniques are generally considered safe.
Acupuncture is also a kind of mind and body practice with CAM. It is a range of procedures involving the stimulation of specific body points. In one form of acupuncture, a practitioner lightly punctures the skin with needles that are then manipulated by hand or by electrical stimulation. Meditation, yoga, and acupuncture are probably the most well known mind and body practices used in the US. Other examples of mind and body practices include deep-breathing exercises, biofeedback, guided imagery, hypnotherapy, progressive relaxation, qi gong, and tai chi.
Manipulative and Body-Based Practices
Manipulative and body-based practices focus primarily on the structures and systems of the body, including the bones and joints, soft tissues, and circulatory and lymphatic systems. Two of the most well known therapies in this category are spinal manipulation and massage therapy.
Spinal manipulation is done by chiropractors and by certain other health care professionals such as physical therapists, osteopathic physicians, and some conventional medical doctors. These professionals use either their hands or a device to apply a controlled force to a joint of the spine, moving it beyond its passive range of motion; the amount of force applied depends on the form of manipulation used.
Massage therapy is a subset of manipulative and body-based approaches that includes a range of hands-on massage techniques. Massage therapy is used most often to relieve pain, reduce stress or anxiety, help sports injuries heal, and generally promote a sense of wellbeing.
Bottom Line
As with any treatment, it is important to consider safety before using complementary or alternative health products and practices. Safety depends on the specific therapy, and each product or practice should be evaluated carefully and in conjunction with a conventional medical health care provider.
Mind and body practices such as meditation and yoga, for example, are generally considered to be safe in otherwise healthy people when practiced appropriately.
Natural products such as herbal medicines or botanicals are often sold as dietary supplements and are readily available to consumers; however, there is a lot we do not know about the safety of many of these products, in part because a manufacturer does not have to prove the safety and effectiveness of a dietary supplement before it is sold to the public. Products are not always consistent across the market, even if the quantities or form are the same. Drug interactions and product contamination are also real concerns with natural products, and therefore this class of products should be used with care.
Author: Kay Rothman, CBS
Reviewed by: Dr. Holly Atkinson, Dr. Preeti Parikh
Host Reviewer: HealthiNation Editors