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Alternative medicine describes any practice which aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested or untestable.Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon.
The terms alternative medicine, complementary medicine, integrative medicine,holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning and are almost synonymous in most contexts. [1] [2] [3] [4]
The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to medical science, although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness. [5] [6] Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not, e.g., the use of the expressions "Western medicine" and "Eastern medicine" to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between evidence-based medicine and treatments that do not work. [5]
Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with functional medical treatment, in a belief that it improves the effect of treatments. [n 1] [8] [9] [10] [11] For example, acupuncture (piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time. [12] [13] [14] Instead, significant drug interactions caused by alternative therapies may make treatments less effective, notably in cancer therapy. [15] [16] Integrative medicine has been described as an attempt to bring pseudoscience into academic science-based medicine. [17] Due to its many names, the field has been criticized by writer Rose Shapiro for what she describes as intense rebranding of what are essentially the same practices. [1]
CAM is an abbreviation of the phrase complementary and alternative medicine. [18] [19] The 2019 World Health Organization (WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into the dominant health care system. They are used interchangeably with traditional medicine in some countries." [20]
Traditional medicine comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the era of modern medicine. The 2019 WHO study defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness." [20]
Holistic medicine is another rebranding of alternative medicine. In this case, the words balance and holism are often used alongside complementary or integrative, claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine.
Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine, [n 2] [n 3] but whose effectiveness has not been established using scientific methods, [n 2] [n 4] [5] [23] [24] [25] or whose theory and practice is not part of biomedicine, [n 3] [n 5] [n 6] [n 7] or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine. [5] [23] [29] "Biomedicine" or "medicine" is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Unlike medicine, [n 5] an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. [n 4] [5] [8] [23] [29]
Terminology has shifted over time, reflecting the preferred branding of practitioners. [30] For example, the United States National Institutes of Health department studying alternative medicine, currently named the National Center for Complementary and Integrative Health (NCCIH), was established as the Office of Alternative Medicine (OAM) and was renamed the National Center for Complementary and Alternative Medicine (NCCAM) before obtaining its current name. Therapies are often framed as "natural" or "holistic", in apparent opposition to conventional medicine which is "artificial" and "narrow in scope", statements which are intentionally misleading. [31] [32]
Prominent members of the science [33] [34] and biomedical science community [22] say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine, because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all. [22] [33] [34] [35] Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. [26] [36] The systems and practices it refers to are diffuse, and its boundaries poorly defined. [37] [38] Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. [39] Some alternative therapies, such as traditional Chinese medicine (TCM) and Ayurveda, have antique origins in East or South Asia and are entirely alternative medical systems; [39] : 13 IOM Report 2005 , p. 18.</ref> others, such as homeopathy and chiropractic, have origins in Europe or the United States and emerged in the eighteenth and nineteenth centuries. [40] Some, such as osteopathy and chiropractic, employ manipulative physical methods of treatment; others, such as meditation and prayer, are based on mind-body interventions. [41] Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another. [42]
Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo. [5] [17] [43] [44] It has been said that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", [34] and that the very idea of "alternative" treatments is paradoxical because any treatment proven to work is by definition "medicine." [45]
Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare. [46] This can refer to the lack of support that alternative therapies receive from medical scientists regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum. [46] In 1993, the British Medical Association (BMA) stated that it [n 8] referred to "...those forms of treatment which are not widely used by the conventional healthcare professions, and the skills of which are not taught as part of the undergraduate curriculum of conventional medical and paramedical healthcare courses". [47] In a US context, a definition coined in 1993 by the Harvard-based physician David M. Eisenberg [48] [49] described alternative medicine as "interventions neither taught widely in medical schools nor generally available in US hospitals". [50] In a definition published in 2000 by the World Health Organization (WHO), CAM was defined as a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system. [51] [52] A widely used [53] descriptive definition devised by the US NCCIH calls it "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine". [54] However, these descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training; [55] alternative medicine is taught in more than half of US medical schools and US health insurers are increasingly willing to provide reimbursement for alternative therapies. [56] In 1999, 7.7% of US hospitals reported using some form of alternative therapy; this proportion had risen to 37.7% by 2008. [57] A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%. [58]
An expert panel at a conference hosted in 1995 by the US Office for Alternative Medicine (OAM), [59] [n 9] devised a theoretical definition [59] of alternative medicine as "a broad domain of healing resources ... other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period". [61] This definition has been widely adopted, [59] and has been cited by the UK Department of Health, [62] attributed as the definition used by the Cochrane Collaboration, [63] and, with some modification,[ dubious ] was preferred in the 2005 consensus report of the US Institute of Medicine. [n 3] This definition, an expansion of Eisenberg's 1993 formulation, is silent regarding questions of the medical effectiveness of alternative therapies. [64] Its proponents hold that it thus avoids relativism about differing forms of medical knowledge and, while it is an essentially political definition, this should not imply that the dominance of mainstream medicine is solely due to political forces. [64] According to this definition, alternative and mainstream medicine can only be differentiated with reference to what is "intrinsic to the politically dominant health system of a particular society of culture". [65] However, there is neither a reliable method to distinguish between cultures and subcultures, nor to attribute them as dominant or subordinate, nor any accepted criteria to determine the dominance of a cultural entity. [65] If the culture of a politically dominant healthcare system is held to be equivalent to the perspectives of those charged with the medical management of leading healthcare institutions and programs, the definition fails to recognize the potential for division either within such an elite or between a healthcare elite and the wider population. [65]
Evidence-based definitions distinguish alternative medicine based on its provision of therapies that are unproven, unvalidated, or ineffective and support of theories with no recognized scientific basis. [66] These definitions characterize practices as constituting alternative medicine when, used independently or in place of evidence-based medicine, they are put forward as having the healing effects of medicine, but are not based on evidence gathered with the scientific method. [8] [22] [12] [13] [54] [67] Exemplifying this perspective, a 1998 editorial co-authored by Marcia Angell, a former editor of The New England Journal of Medicine , argued that:
It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments. [22]
This line of division has been subject to criticism on the grounds that not all forms of standard medical practice have adequately demonstrated evidence of benefit, [n 5] [68] [69] and that most conventional therapies, if proven to be ineffective, would not later be classified as alternative. [59] Another definition is that alternative medicine refers to a diverse range of related and unrelated products, practices, and theories ranging from biologically plausible practices and products and practices with some evidence, to practices and theories that are directly contradicted by basic science or clear evidence, and products that have been conclusively proven to be ineffective or even toxic and harmful. [n 3] [37] [70] [5]
Proponents of an evidence-base for medicine [n 10] [72] [73] [74] [75] such as the Cochrane Collaboration take a position that all systematic reviews of treatments, whether "mainstream" or "alternative", ought to be held to the current standards of scientific method. [76] In 2011, the Cochrane Collaboration proposed that indicators of a therapy's level of acceptance include government licensing of practitioners, coverage by health insurance, statements of approval by government agencies, and recommendation as part of a practice guideline; and that if something is currently a standard, accepted therapy, then it is not likely to be widely considered as alternative. [59]
The public information website maintained by the National Health and Medical Research Council (NHMRC) of the Commonwealth of Australia uses the acronym "CAM" for a wide range of health care practices, therapies, procedures and devices not within the domain of conventional medicine. In the Australian context this is stated to include acupuncture; aromatherapy; chiropractic; homeopathy; massage; meditation and relaxation therapies; naturopathy; osteopathy; reflexology, traditional Chinese medicine; and the use of vitamin supplements. [77]
The Danish National Board of Health's Council for Alternative Medicine (Sundhedsstyrelsens Råd for Alternativ Behandling (SRAB)), an independent institution under the National Board of Health (Danish: Sundhedsstyrelsen), uses the term "alternative medicine" for:
Allopathic medicine or allopathy is a pejorative term used by proponents of alternative medicine to refer to modern scientific systems of medicine, [79] such as the use of pharmacologically active agents or physical interventions to treat or suppress symptoms or pathophysiologic processes of diseases or conditions. [80] [81] The expression was coined in 1810 by the creator of homeopathy, Samuel Hahnemann (1755–1843). [82] Among homeopaths and other alternative medicine advocates, the expression "allopathic medicine" is still used to refer to "the broad category of medical practice that is sometimes called Western medicine, biomedicine, evidence-based medicine, or modern medicine." [83]
Use of the term remains common among homeopaths and has spread to other alternative medicine practices. The meaning implied by the label has never been accepted by conventional medicine and is still considered pejorative by some. [84] William Jarvis, an expert on alternative medicine and public health, [85] states that "although many modern therapies can be construed to conform to an allopathic rationale (e.g., using a laxative to relieve constipation), standard medicine has never paid allegiance to an allopathic principle" and that the label "allopath" was "considered highly derisive by regular medicine." [86]
Many modern science-based medical treatments (antibiotics, vaccines, and chemotherapeutics, for example) do not fit Samuel Hahnemann's definition of allopathy, as they seek to prevent illness, or remove the cause of an illness by acting on the cause of disease. [87] [88]
Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability or evidence of effectiveness. Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of mainstream medicine and do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.
Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians, believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like". Homeopathic preparations are termed remedies and are made using homeopathic dilution. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product. Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.
Naturopathy, or naturopathic medicine, is a form of alternative medicine. A wide array of practices branded as "natural", "non-invasive", or promoting "self-healing" are employed by its practitioners, who are known as naturopaths. Difficult to generalize, these treatments range from the pseudoscientific and thoroughly discredited, like homeopathy, to the widely accepted, like certain forms of psychotherapy. The ideology and methods of naturopathy are based on vitalism and folk medicine rather than evidence-based medicine, although practitioners may use techniques supported by evidence. The ethics of naturopathy have been called into question by medical professionals and its practice has been characterized as quackery.
Reiki is a pseudoscientific form of energy healing, a type of alternative medicine originating in Japan. Reiki practitioners use a technique called palm healing or hands-on healing through which, according to practitioners, a "universal energy" is transferred through the palms of the practitioner to the patient, to encourage emotional or physical healing.
Allopathic medicine, or allopathy, is an archaic and derogatory label originally used by 19th-century homeopaths to describe heroic medicine, the precursor of modern evidence-based medicine. There are regional variations in usage of the term. In the United States, the term is sometimes used to contrast with osteopathic medicine, especially in the field of medical education. In India, the term is used to distinguish conventional modern medicine from Siddha medicine, Ayurveda, homeopathy, Unani and other alternative and traditional medicine traditions, especially when comparing treatments and drugs.
The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), and renamed the National Center for Complementary and Alternative Medicine (NCCAM) before receiving its current name in 2014. NCCIH is one of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the United States Department of Health and Human Services.
Craniosacral therapy (CST) or cranial osteopathy is a form of alternative medicine that uses gentle touch to feel non-existent rhythmic movements of the skull's bones and supposedly adjust the immovable joints of the skull to achieve a therapeutic result. CST is a pseudoscience and its practice has been characterized as quackery. It is based on fundamental misconceptions about the anatomy and physiology of the human skull and is promoted as a cure-all for a variety of health conditions.
The history of alternative medicine covers the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. It includes the histories of complementary medicine and of integrative medicine. "Alternative medicine" is a loosely defined and very diverse set of products, practices, and theories that are perceived by its users to have the healing effects of medicine, but do not originate from evidence gathered using the scientific method, are not part of biomedicine, or are contradicted by scientific evidence or established science. "Biomedicine" is that part of medical science that applies principles of anatomy, physics, chemistry, biology, physiology, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice.
Mind–body interventions (MBI) or mind-body training (MBT) are health and fitness interventions that are intended to work on a physical and mental level such as yoga, tai chi, and Pilates.
Manual therapy, or manipulative therapy, is a physical treatment primarily used by physical therapists, occupational therapists to treat musculoskeletal pain and disability; it mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation. It is also used by Rolfers, massage therapists, athletic trainers, osteopaths, and physicians.
Alternative cancer treatment describes any cancer treatment or practice that is not part of the conventional standard of cancer care. These include special diets and exercises, chemicals, herbs, devices, and manual procedures. Most alternative cancer treatments do not have high-quality evidence supporting their use and many have been described as fundamentally pseudoscientific. Concerns have been raised about the safety of some purported treatments and some have been found unsafe in clinical trials. Despite this, many untested and disproven treatments are used around the world.
The Research Council for Complementary Medicine (RCCM) is a charitable organisation (UK Registered Charity Number 1146724) founded in 1983 to develop and promote good quality research into alternative and complementary medicine (CAM) and enhance evidence-based medicine in this area.
Bachelor of Ayurvedic Medicine and Surgery (B.A.M.S.) is a professional degree focused on Ayurveda offered in India, Nepal, Bangladesh, and Sri Lanka.
Alternative therapies for developmental and learning disabilities include a range of practices used in the treatment of dyslexia, ADHD, autism spectrum disorders, Down syndrome and other developmental and learning disabilities. Treatments include changes in diet, dietary supplements, biofeedback, chelation therapy, homeopathy, massage and yoga. These therapies generally rely on theories that have little scientific basis, lacking well-controlled, large, randomized trials to demonstrate safety and efficacy; small trials that have reported beneficial effects can be generally explained by the ordinary waxing and waning of the underlying conditions.
Alternative veterinary medicine is the use of alternative medicine in the treatment of animals. Types alternative therapies used for veterinary treatments may include, but are not limited to, acupuncture, herbal medicine, homeopathy, ethnomedicine and chiropractic. The term includes many treatments that do not have enough evidence to support them being a standard method within many veterinary practices.
The Ministry of Ayush, a ministry of the Government of India, is responsible for developing education, research and propagation of traditional medicine and alternative medicine systems in India. Ayush is a name devised from the names of the alternative healthcare systems covered by the ministry: ayurveda, yoga & naturopathy, Unani, Siddha, Sowa Rigpa, and homeopathy.
Qigong, is a system of coordinated body-posture and movement, breathing, and meditation said to be useful for the purposes of health, spirituality, and martial arts training. With roots in Chinese medicine, philosophy, and martial arts, qigong is traditionally viewed by the Chinese and throughout Asia as a practice to cultivate and balance the mythical life-force qi.
The Office of Cancer Complementary and Alternative Medicine (OCCAM) is an office of the National Cancer Institute (NCI) in the Division of Cancer Treatment and Diagnosis. OCCAM was founded in 1998 and is responsible for NCI's research agenda in pseudoscientific complementary and alternative medicine (CAM), as it relates to cancer prevention, diagnosis, treatment, and symptom management. The OCCAM differs from the National Center for Complementary and Integrative Health in that it is exclusively focused on cancer, while the NCCIH funds a much broader program of NIH research into CAM for all diseases and disorders. It last produced an annual report in 2011 and spent $105 million on CAM research in 2011.
Michael H. Cohen is an American attorney. He is the founder of the Cohen Healthcare Law Group, and a former professor at Harvard Medical School and the Harvard School of Public Health. Cohen has authored books on health-care law and policy.
Complementary medicine, defined as health care which lies for the most part outside the mainstream of conventional medicine.
By the mid-1990s, the notion that some alternative therapies could be complementary to conventional medicine began to change the status of...alternative medicine. The 21st century is witnessing yet another terminological innovation, in which CAM and conventional medicine are becoming integrative.
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