Chapter 4: Complementary and Alternative Medicine

  • Overview of CAM: Complementary and alternative medicine refers to medical practices that are not typically part of standard medical care, including herbal remedies, acupuncture, and yoga.

  • Importance of CAM: Many individuals turn to CAM for various reasons, including dissatisfaction with conventional treatments, cultural beliefs, or a desire for a more holistic approach to health.

  • Evidence for CAM: While some CAM modalities are supported by scientific research, others lack substantial evidence, highlighting the need for careful evaluation and consideration.

History of Complementary and Alternative Medicine

  • National Health Interview Survey (NHIS) is an annual study, conducted by CDC’s National Center for Health Statistics showed a massive increased in CAM w/ natural products at 17.7%, deep breathing 10.9% and Yoga/Tai, Qi Gong being at 10%.

  • Back pain followed by neck pain for the most common reasons for individuals seeking CAM therapies, as many report that traditional medical treatments did not provide sufficient relief.

  • Out-of-pocket amount that was spent in the United States on complementary health approaches was $30.2 billion. Americans alone spent $14.7 on visits to complementary practitioners such as chiropractors.

    • 30% of what they spend out of pocket on CAM; 12.8 billion alone on natural product supplements…which is about ¼ of total expenditure on out of pocket prescription meds.

  • NCCIH or National Center for Complementary and Integrative Health plays a pivotal role in researching the efficacy and safety of these practices and products.

    • Released it’s most recent plan on 2016:

      • Advance fundamental science and methods development.

      • Improve care for hard-to-manage symptoms.

      • Foster health promotion and disease prevention.

      • Enhance complementary and integrative health research workforce.

      • Disseminate knowledge about effective complementary and alternative therapies to healthcare providers and the general public.

    • Top scientific priorities are as follows:

      • Nonpharmacologic management of pain.

      • Neurobiological effects and mechanisms.

      • Innovate approaches for establishing biological signatures of natural products.

      • Disease prevention and health promotion across the life span.

      • Clinical trials utilizing innovate study designs to assess complementary health approaches and their integration into healthcare.

      • Communication strategies and tools to enhance scientific literacy and understanding of clinical research (NCCIH, 2021).

    • Pain management is a major emphasis in its research efforts and it is the most public health problem for Americans.

      • 126 million adults report some pain in previous three months with 25 million adults suffering from daily chronic pain and 23 million reporting major pain.

    • NCCIH identifies strategies for promoting health and preventing disease. It examines behavioral risk factors such as unhealthy diet, obesity, sedentary life, alcohol, diabetes and more!

Complementary and Alternative Healthcare Modalities

Ayurvedic Medicine

  • Ayurvedic, sanskrit word for science of life, was originally described in ancient Hindu texts called Vedas.

  • Based on theory that five great elements—ether, air, fire, water and earth— are basis for all living systems. They all combine to form doshas, the three vital energies which regulate everything in nature.

    • Vata → Composed of air and ether.

    • Pita → Composed of fire and water.

    • Kapha → Composed of water and earth.

  • At conception, doshas combine in a unique way for each individual: Producing Prakarti, which defines their physical and mental characteristics throughout life.

  • Ayurveda practitioners seek to balance doshas through methods such as herbal remedies, yoga, meditation and massage.

Yoga Medicine

  • Yoga is an ancient system of exercises and breathing techniques to encourage physical and spiritual well-being.

    • Guidelines for well-being, good nutrition and hygiene are present.

  • Asanas → Physical postures to improve physical body and calm nerves.

  • Pranayamas → Breathing techniques and meditations designed to improve spiritual well-being.

  • Chakras → Energy centers in the body that correspond to physical, emotional, and spiritual states, believed to influence overall health and wellness.

  • Yoga has many health benefits: Increased strength, balance and flexibility.

Traditional Chinese Medicine

  • Tradition Chinese Medicine (TCM) is the term used for group of ancient healing practices that date back some 2,000 years to 200 BCE.

    • Many Asian cultures have their own forms of TCM.

  • Based on diagnosis from pattern of symptoms rather than endeavoring to identify specific illness; focus on person’s body, mind, spirit and emotions as a complete whole.

Theory of Qi

  • Qi is the vital life force that animates all things. Qi flows through the 12 meridians that run through the body. Physical, emotional, and mental harmony rely on the flow of qi. Qi has two parts, energy or power, and conscious intelligence.

    • These parts are found in organ systems and allow them to preform and allow to perform their physical and energetic functions.

    • Qi creates all movement, protects the body, provides for harmonious transformation, and maintains balance within the body, thus influencing health and well-being.

      • Spiritual in origin, makes up and moves through all livings though.

The Five Elements Theory

  • Five elements → based on perception of the relationships between various elements, namely Wood, Fire, Earth, Metal, and Water, which interact dynamically to influence physical health, emotional well-being, and spiritual balance.

Yin and Yang Theory

  • Yin and Yang theory → Everything is made up of two polar energies. Neither can exist without the other, as they represent complementary forces that create harmony and balance within the body.

  • Yin is feminine energy exhibiting moon and night, passivity, darkness, interior-thought, downwardness and decrease.

  • Yang is masculine energy exhibiting sun and day, energy, stimulation, movement, excitement, vigor, upwardness and increase.

Meridian Theory

  • Meridians are channels through which qi, blood and information flow through all parts of the body; 12 meridians exist with six being yin and yang.

  • Each Meridian is associated or corresponds to specific organs and physiological functions, playing a crucial role in the balance of energy within the body.

Qigong

  • Qigong “energy work” → Part of TCM that involves movement, breathing and meditation; it’s intent is to improve qi throughout the body.

  • Tai chi → Ancient noncombative martial art that combines slow, controlled movements with deep breathing and is practiced for its health benefits and to promote relaxation.

Naturopathy

  • Naturopathy → Naturopathic medicine is an holistic system of medicine based on the healing power of nature. Naturopathy was influenced by Ayurveda medicine, TCM, and Native American medicine.

  • Based upon the healing power of the body; Emphasizes preventative care and the importance of treating the whole person—body, mind, and spirit—in order to achieve optimal health.

Dietary Herbals

  • Dietary “ingredient” → Intended to supplement human diet such as vitamins, minerals, amino acids, enzymes, extracts and herb/botanical.

  • Dietary “supplements” → Probiotics, prebiotics, and other live microorganisms that can provide health benefits when consumed in adequate amounts.

  • Cannabis → Herbal remedy sold in many forms such as supplements, gummies, and in food.

    • Cannabis → refers to all varieties of the Cannabis sativa plant, which can be used for both therapeutic and recreational purposes, depending on the cannabinoid content and formulation.

    • Marijuana → commonly used to refer to the dried flowers and leaves of the Cannabis plant, often consumed for its psychoactive properties or medicinal benefits, depending on the dosage and method of administration.

    • Can help in treating epilepsy, nausea and vomiting, loss of apetite, chronic pain, and certain mental health disorders, showcasing its potential benefits in various therapeutic applications.

    • Also used in mental health to help manage conditions such as anxiety, depression, and PTSD, illustrating its versatility as a treatment option.

    • Cannabis use disorder and pregnancy.

Reiki

  • Reiki → Complementary health approach in which practitioners place their hands lightly on or just above a person with the goal of facilitating the body’s own healing response.

  • It’s results have been inconsistent across various studies, leading to ongoing debate about its efficacy and safety in treating specific conditions.

Meditation

  • Meditation → Refers to group of mental techniques intended to provide relaxation and mental harmony, quiet one’s mind, and increase awareness.

  • Found in several cultures for thousand of years— Christian, Jewish, Buddhist, Hindu, and Islamic religious traditions.

  • Meditation is utilized to decrease stress and anxiety levels, improve mood, and positively affect heart disease and physical illness.

  • Mindfulness meditation → Origin in Buddhist traditions. It is the concept of increasing awareness and acceptance of the present.

  • Transcendental meditation → It’s origins are in Indian Vedic tradition; practice is designed to allow practitioner to experience ever-finer levels of thought until source of thought is experienced.

    • Mantra → A sound, word, or phrase repeated to aid concentration in meditation and achieve a deeper state of awareness.

    • Spiritual meditation → A practice that involves focusing the mind on spiritual aspects or connections, often incorporating techniques from various religious traditions to deepen one's spiritual awareness and foster a sense of unity with a higher power.

  • Mental focus, passive attitude, decreased muscle tone and a quiet environment.