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Complementary and alternative medicine (CAM)

CAM generally refers to modalities, practices, techniques, and systems of healing that are used together with ("complementary to") or instead of ("alternative to") conventional medicine.

Among the modalities that are usually included as CAM are:

  • Chiropractic
  • Acupuncture
  • Massage therapy
  • Mind-body techniques (e.g., biofeedback, guided imagery, yoga, and meditation)
  • Some forms of nutritional therapy
  • Dietary supplements (including herbs)
  • Homeopathy
  • Naturopathic medicine
  • Various forms of energy healing
  • The indigenous healing systems of the many ethnic groups in the United States

Over the past decade, several nationwide surveys have documented a substantial and growing usage of CAM practices and products by the American public. These surveys have found that most CAM users seek out conventional medical treatment first, and then turn to CAM practitioners. Most people appear to use CAM in conjunction with, not as a replacement for, conventional medical therapy, and many seek out care that integrates the best of a variety of approaches.

Up to 42% of the population may use CAM methods. And even higher use of CAM therapies have been found among people with chronic and life-threatening conditions and chronic pain. For example, a study at a major cancer center indicated that 69% of patients included CAM approaches as part of their cancer care.

Scientific study of CAM techniques is still in its infancy. For example, in 1997 the National Institutes of Health issued a consensus statement on the use of acupuncture, one of the most common CAM modalities. While there have been hundreds of studies using acupuncture, most were of such poor scientific quality that the panel could only find clear evidence for the effectiveness of acupuncture on various forms of nausea and only one pain condition (postoperative dental pain). Acupuncture is thought to stimulate our internal pain control system and production of endorphins, but this has also not been clearly demonstrated.

Many other CAM modalities have been reported to have significant benefit for chronic pain but even less scientific data exists to inform patients regarding their efficacy and safety. It is clearly time to embark on serious study of ancient and alternative medical approaches using the tools of modern science. It is promising and exciting that recent data on mind-body interactions support the fundamental basis of most CAM approaches, namely that the mind, brain, and body are best treated as an integrated whole.

Efforts are underway to promote the development of new models of medical care and provide a scientific basis for integrative medicine. At present, decisions on whether to try CAM techniques for pain control or which techniques might be most appropriate must be made by each person without the benefit of clear scientific data.

If you are considering a CAM approach, it will be important to gather as much information as you can about the methods and especially the provider. As with any provider, look for his or her credentials, number of years experience, and ask direct questions on what to expect and possible side effects from the treatment.

Adapted from IFFGD Publication #140 by Bruce D. Naliboff, PhD, Clinical Professor of Medical Psychology in the Dept. of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA; Co-director, UCLA Center for Integrative Medicine; and Chief of the Psychophysiology Research Laboratory, West Los Angeles VA GLA Health Care, Los Angeles, CA

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