Sep 01, 1996
Alternative and Complementary Medicine are receiving increasing public and scientific attention. There is a great deal of confusion about what these labels mean and what we know about them. Alternative Medicine is usually described as practices not generally accepted as part of the conceptual or methodological approaches used by licensed physicians or other licensed health care providers. However, some licensed physicians and other health care providers may use an Alternative Medicine method or refer patients to practitioners of an Alternative Medicine method. The Alternative Medicine method is often used alone and not in conjunction with generally accepted clinical procedures; but not always. The term Complementary Medicine is usually used when an Alternative Medicine method is used in conjunction with generally accepted procedures.
There is also a grey zone between conventional treatment and Alternative Medicine. There are procedures used by some conventional health care providers (often specialists) which are considered by other clinicians to be “acceptable”, but are not in general use; examples of these are behavior modification, hyperbaric oxygenation and spinal manipulation. In some circumstances, these procedures are considered to be conventional therapy and in other circumstances they are considered to be Alternative Medicine. The difference is usually based on who is administering the procedure and/or for what purpose. For example: behavior modification therapy when used by a psychiatrist is considered conventional therapy; when it is used by a spiritualist it is considered Alternative Medicine. Or, when hyperbaric oxygen therapy is used for the treatment of carbon monoxide poisoning it is considered conventional therapy; when it is used for the treatment of cancer, it is considered Alternative Medicine. Another example is the use of spinal manipulation for back pain: when it is used by a physician it is considered conventional therapy; when it is used by others it is considered Alternative Medicine.
Methods used by Alternative Medicine practitioners are believed by some to be of value in maintaining health, preventing disease or dysfunction, and/or treating disease or dysfunction. They include a wide variety of methods such as herbal medicine, mega vitamin therapies, health foods, Qigong, acupuncture, homeopathic medication, colonic irrigation, exercise therapies, cranial-sacral manipulation, force field application, and meditation. The practitioners using these alternative methods are generally not licensed by state governments as health care clinicians, but sometimes are licensed for a specific method (e.g. acupuncture) or in other fields (e.g. nursing).
Is Alternative Medicine useful? People utilizing Alternative Medicine generally do so for two reasons: (1) they feel better when using it; and, (2) they are dissatisfied with the techniques or the results of generally accepted clinical methods used by physicians and other conventional therapists. There are reports of good results of an Alternative Medicine methodology from those who utilize it or administer it. However, there are many problems with these individual reports from persons receiving Alternative Medicine (“anecdotal reports”) or with reports from Alternative Medicine practitioners describing their own experiences (“case series reports”). These problems include the validity of the diagnosis of the reasons for poor health or loss of function, the biases of the recipient or practitioner when reporting on the short-term results of therapy, the lack of reports on the long- term results of therapy. Another problem is a nearly complete lack by Alternative Medicine practitioners of systematic and scientifically acceptable studies to evaluate their beliefs and experiences. In a few instances, a method of Alternative Medicine has been put to a reliable scientific test and failed to show effectiveness; an example is the use of acupuncture for alleviating hearing loss. The Foundation doesn’t know of any examples where effectiveness has been demonstrated in a scientifically acceptable study.
In order to respond to the need to know about the safety and usefulness of these procedures, the medical research arm of the U.S. government, the National Institutes of Health (NIH), has established a Center of Alternative Medicine. This unit is charged with the responsibility of assisting in the development and support of scientifically acceptable studies evaluating the results of the methods used in Alternative Medicine. Progress in the development of these research studies is slow, but a meaningful beginning has been made. The National Center for Complementary and Alternative Medicine has developed a directory of alternative health care associations. The directory includes associations for: biofeedback; art; music, and humor therapy; massage therapy; acupuncture; Feldenkrais and other alternative therapies. To receive the directory, call (301) 402-2466 and request “Fact Sheet #10″.
Comment: Is there any acceptable scientific evidence that methods used in Alternative Medicine are useful for the prevention of cerebral palsy or in the meaningful treatment of persons with disabilities due to cerebral palsy? The answer at this time is “no.” Do persons with disabilities “feel better” when using Alternative Medicine? Sometimes; however, is this due to: the positive effect of trying something new? Receiving increased focused attention? The treatment? We don’t know. Will it do harm? Usually not; but, like any treatment, there are reports of injury. What to do? Seek advice from people you trust. Make sure you know what is being offered and why it is being offered; also, learn what are the short-term and long-term results from others whom you trust and who have had the treatment. The treatments may be expensive and usually are not covered by insurance. Hopefully, in the reasonably near future, the NIH will have some information for us. Remember, the history of the treatment of persons with disabilities due to cerebral palsy is filled with “enthusiastically hailed, revolutionary new approaches,” which are now no longer in use. Keep an open mind; be prudent; be cautious.
Formerly Office of Alternative Medicine (1996). Updated named to National Center for Complementary and Alternative Medicine (1999).