Since the 1960s more Americans have turned to complementary and alternative medical (CAM) treatments. According to a nationwide government survey released in 2004, 36 percent of U.S. adults aged 18 years and over use some form of CAM. They visit herbalists, acupuncturists, chiropractors and other providers of nonconventional therapies. When prayer specifically for health reasons is included in the definition of CAM, the number of U.S. adults using some form of CAM in the past year rises to 62 percent.

What is complementary and alternative medicine, and why are people spending time and money on it?

Complementary and alternative medicine covers therapeutic practices, approaches and philosophies outside mainstream Western medicine. Many complementary and alternative therapies are considered "holistic." They take into account the whole person in the healing process, not just the person's physical being but the mental, emotional and spiritual sides as well. Many also advocate wellness and disease prevention - two concepts many Americans have taken to heart as they try to stop smoking, eat better and exercise more to live longer, healthier lives.

One important way that complementary and alternative therapies differ from conventional or modern medicine is that they typically have not been subjected to rigorous scientific testing in clinical trials. In such trials, an experimental therapy is compared with a known therapy or to a placebo in sufficient numbers of patients to determine whether the therapy has a significant benefit. As complementary and alternative practices have become more popular, researchers increasingly are testing some of them in this way and publishing their results.

The major fields of alternative practice

Alternative health care involves dozens of different specialties. The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH) groups CAM practices into four domains, recognizing there can be some overlap. In addition, NCCAM studies CAM whole medical systems, which cut across all domains.

• Whole Medical Systems integrate theory and practice. They often have evolved apart from and earlier than the conventional medical approach used in the United States. Examples of whole medical systems that have developed in Western cultures include homeopathic medicine and naturopathic medicine. Examples of systems that have developed in non-Western cultures include traditional Chinese medicine and Ayurveda.



• Mind-body medicine explores the ability of the mind to affect and, perhaps, heal the body. Some examples are yoga, hypnosis, biofeedback, prayer, music, dance and meditation. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive-behavioral therapy).



• Biologically based therapies use herbs, special diets such as Pritikin and macrobiotic, and other natural products to prevent and treat illnesses. This group also includes drugs and vaccines not yet accepted or tested by mainstream medicine, such as bee pollen and hyperbaric oxygen, as well as procedures such as iridology.



• Manipulative and body-based systems refer to treatments based on manipulation and/or movement of the body, including chiropractic medicine, massage, reflexology.



• Energy Medicine involves the use of energy fields. There are two types:



• Biofield medicine, which includes therapeutic touch and reiki, intends to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields.
• Bioelectromagnetic applications use the body's response to electromagnetic fields to heal the body.

Integrating mainstream and alternative medicine

Although alternative therapies traditionally had not been taught in medical schools or used in hospitals, things are changing. A survey of 117 U.S. medical schools found nearly two-thirds offer courses on complementary and alternative medicine. Nearly one-third of the courses are required. Centers for researching alternative therapies have been established at a number of universities.

In 1992 the NIH established the Office of Alternative Medicine (now The National Center for Complementary and Alternative Medicine) to help determine which medical conditions might be best helped by complementary and alternative methods.

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External Sources NCCAM, National Institutes of Health. What Is CAM? Accessed May 31, 2007. NCCAM, National Institutes of Health. Are You Considering Using CAM? Accessed May 31, 2007. NCCAM, National Institutes of Health. Statistics on CAM Use in the United States. Accessed May 31, 2007.

This article was reviewed and updated June 2007.