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The Basics of Complementary and Alternative Medicine

Helping you understand complementary and alternative medicine.

Complementary and alternative medicine has been around for years. In fact, it’s far from new. It has been used for centuries and more people are recognizing its benefits as new research continues to be published. So, what exactly is the definition of complementary and alternative medicine (CAM), and how does it differ from Western medicine (aka conventional or modern medicine)?


In simple terms, complementary and alternative medicine, commonly abbreviated as the acronym CAM, is a group of therapies that are not considered to be conventional nor as the standard of treatment for a specific illness or condition.


Conventional medicine usually involves the use of drugs, radiation, or surgery to treat different symptoms or diseases.


When CAM is used in addition to or together with conventional medicine it is known as complementary medicine. However, when CAM is used instead of or in place of conventional medicine it is known as alternative medicine.


These definitions do not paint the full picture of complementary and alternative medicine, but they do explain the main concept, nonetheless.


According to a national follow-up survey following the trends in alternative medicine in the United States from 1990 to 1997, CAM use increased substantially. At that time over a third of American adults agreed to using some form of CAM, with the total number of visits to CAM providers exceeding those of primary-care visits via extrapolation data. [2]


This survey was completed in 1997, but trends in CAM have continued to increase since then. I could only imagine where the statistics are at now in 2021.


CAM is everywhere. From herbal supplements to massage therapy, most Americans have used or currently use a form of CAM nowadays.


Just as the use of CAM has evolved, so has its definition.


Generally speaking, CAM used to be known as therapies that are not taught widely in medical schools nor available in a medical setting, but in present day this notion is no longer true. CAM has become more widely accepted by mainstream medicine and has been integrated into the curriculum of most medical and pharmacy schools.


Because CAM has become more common, understanding the terms that once classified a specific therapy as complementary and alternative medicine versus conventional can be a bit confusing. To avoid being confused, it’s important to know that a CAM therapy does not stop being classified as CAM after it has been proven to be safe and effective for a specific condition and becomes a part of conventional medicine. Instead, it’s still considered complementary and alternative medicine, not conventional. This notion is the reason why you can find several different definitions of CAM.


For a more modernized and thorough definition of CAM, I have revised the following definition from the U.S. Institute of Medicine’s Committee on the Use of Complementary and Alternative Medicine by the American Public:


Complementary and alternative medicine (CAM) is a broad domain of therapies that involve different health systems and practices and their accompanying theories and beliefs. These therapies are not considered part of the dominant health system of a particular society or culture in a given historical period. These therapies are often perceived by their users to be associated with positive health outcomes. Boundaries within and between CAM and the dominant health system are not always sharp or fixed. [4]


The last line of this definition is essential to understanding CAM. Let’s take yoga for example. If yoga were clinically proven to help with depression and most doctors started prescribing it, yoga would still be considered CAM even though it would be a part of conventional/Western medicine.

What is the National Center for Complementary and Integrative Health (NCCIH)?

The National Center for Complementary and Integrative Health (NCCIH) is the lead government agency assigned to complete scientific research on complementary and integrative health approaches.


According to their website they are “1 of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services.”


The former name of the NCCIH used to be the National Center for Complementary and Alternative Medicine (NCCAM), but the name was changed to its current name the National Center for Complementary and Integrative Health (NCCIH) in December 2014.


The mission of NCCIH is “to determine, through rigorous scientific investigation, the fundamental science, usefulness, and safety of complementary and integrative health approaches and their roles in improving health and health care.”


If you are looking to find a brief summary of current research on different CAM therapies, then the search tool on the NCCIH’s website is a good place to start.

What are the five categories of CAM therapy?

The NCCIH defines complementary and alternative medicine, “as a group of diverse medical and health care systems, practices, and products not presently considered to be part of conventional medicine.”


To further describe which therapies fit into the description of complementary and alternative medicine, the NCCIH has divided CAM into five different categories. The categories are as follows:

  1. Alternative Medical Systems: these involve whole medical systems that were developed separately from Western Medicine. These therapies can stand alone without Western Medicine. Examples are:

  2. traditional Chinese medicine

  3. ayurvedic medicine

  4. homeopathy

  5. naturopathy

  6. Mind-Body Interventions: these include therapies that focus on the power of mind which in turn has a positive impact on the physical body. Examples are:

  7. meditation

  8. prayer

  9. yoga

  10. deep breathing exercises

  11. hypnotherapy

  12. acupuncture

  13. expressive therapies (dance, art and music)

  14. behavioral therapy

  15. group therapy

  16. Biologically Based Treatments: these involve treatments that use substances that occur in nature. Examples are:

  17. special diets, functional foods

  18. natural products

  19. herbal medicines, dietary supplements, vitamins, and minerals

  20. probiotics

  21. Manipulative and Body-Based Methods: these include practices that involve the movement or manipulation of the body. Examples are:

  22. chiropractic

  23. massage therapy

  24. reflexology

  25. Energy Therapies: these involve the manipulation and application of energy fields for healing such as Reiki, therapeutic touch, and qi gong. This category is divided into two parts.

  26. Biofield therapies which are interventions that affect energy fields that surround and penetrate the human body by applying direct or indirect pressure on these fields.

  27. Bioelectromagnetic-based therapies which include the use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating current or direct current fields.

If you would like more information on the different examples of each category of CAM, don’t worry. I will define and discuss the different types in future blog posts.

Why do people use CAM therapy?

After reading the results of several studies, involving the use of CAM, it seems that the pursuit of wellness is the main reason people use CAM.


In a study published in 1998, Austin and his colleagues set out to determine the main reason people seek out CAM. Results of their study concluded that majority of alternative medicine users incorporate CAM into their health care regimen because these alternatives are more consistent with their own values, beliefs, and philosophical orientations toward balanced health and life. [1]


Contrary to popular belief, this study showed that most people do not use CAM because they are dissatisfied with conventional medicine or their current health treatment. [1]


Another study found that most people (79%) “perceive the combination of alternative medicine with conventional medicine to be superior to either one alone,” and I also believe that optimal health is best achieved by combining these two methods (alternative and conventional medicine) via complementary medicine. [3]


Even though most people acknowledge the benefits of complementary medicine, that same study found that most people do not disclose to their doctors that they use complementary and alternative medicine. 61% of people said, "It wasn't important for the doctor to know," 60% said, "The doctor never asked," 31% said, "It was none of the doctor's business,", 20% said, "The doctor would not understand,” 14% thought their doctor would disapprove of or discourage CAM use, and only 2% thought their doctor might not continue as their provider. [3]


Despite how you may feel, it is important to let your doctor and pharmacist know about the current supplements or natural products you are taking for different health conditions. Sometimes these products can interact with your current medications or should not be used if you have certain health conditions, so it’s very important to notify your health care providers to reduce your risk of causing harm to your health.

What should be my takeaway?

Complementary and alternative medicine can play an important role in your health care regimen. With more scientific evidence supporting its use, many people have witnessed the positive impact CAM has had on their health.


There are five categories of CAM: alternative medical systems, mind-body interventions, biologically based treatments, manipulative and body-based methods, and energy therapies.


When deciding which form of complementary and alternative medicine will benefit you, it’s important to do your research. As with anything, you must equip yourself with proper information before making new decisions about your health. Once you’ve decided, please notify your doctor and pharmacist of any dietary supplements, herbal products, or etc. that you start to use or ingest regularly to avoid drug interactions and unwanted side effects.


If you choose to go to a complementary and alternative medicine provider, get to know them. Find out about their education and credentials and see if they will work with your conventional doctor. You deserve to be treated with the best care, and ensuring that all of your health care providers are on the same page with your health and wellness goals, will only help with that.


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References

  1. Astin, J. A. (1998). Why Patients Use Alternative Medicine. JAMA, 279(19), 1548. https://doi.org/10.1001/jama.279.19.1548

  2. Eisenberg, D. M., Davis, R. B., Ettner, S. L., Appel, S., Wilkey, S., Van Rompay, M., & Kessler, R. C. (1998). Trends in Alternative Medicine Use in the United States, 1990-1997. JAMA, 280(18), 1569. https://doi.org/10.1001/jama.280.18.1569

  3. Eisenberg, D. M., Kessler, R. C., Van Rompay, M. I., Kaptchuk, T. J., Wilkey, S. A., Appel, S., & Davis, R. B. (2001). Perceptions about complementary therapies relative to conventional therapies among adults who use both: Results from a national survey. Annals of Internal Medicine, 135(5), 344. https://doi.org/10.7326/0003-4819-135-5-200109040-00011

  4. Institute of Medicine (US) Committee on the Use of Complementary andAlternative Medicine by the American Public. (1970, January 1). Introduction. Complementary and Alternative Medicine in the United States. https://www.ncbi.nlm.nih.gov/books/NBK83804/.

  5. U.S. Department of Health and Human Services. (n.d.). About NCCIH. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/about.

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