Complementary and alternative medicine

Also called complementary and alternative therapy, natural medicine, herbal remedies, non-conventional medicine and holistic medicine

The term complementary and alternative medicine (CAM) is usually used to describe a medical product or practice that is not standard medical care. When this is used together with conventional medicine, it's considered complementary and when it is used instead of conventional medicine, it's considered alternative.

What are some examples of CAM?

Many different areas make up the practice of CAM.  They are also called complementary and alternative therapy, natural medicine, herbal remedies, non-conventional medicine and holistic medicine. The following are a few examples.

 Example  Description
Acupuncture Acupuncture is when fine, solid needles are put into any part of your body. In New Zealand, acupuncture includes different philosophies of needling. Acupuncture may be referred to as traditional Chinese acupuncture, Western or medical acupuncture or dry needling. Some methods of acupuncture do not even involve the insertion of a needle, such as in acupressure.
Aromatherapy Aromatherapy is the use of essential oils through inhalation and vaporisation, or by use in a bath or shower, massage, spritzer sprays, skin care or compresses. Care needs to be taken when using any essential oils, particularly for babies, children, the elderly or during pregnancy. It is not recommended you apply undiluted essential oils to your body. Oils should always be stored away from children and should not be swallowed.

Ayurveda Ayurveda is a traditional Indian system of healing. It includes diet, supplements, yoga, meditation and massage.
Traditional Chinese medicine (TCM) TCM includes many different treatments such as acupuncture, Chinese herbal medicine, moxibustion, cupping, tuina and tai chi. Acupuncture and Chinese herbal medicine are the most well known form of CAM in many Western countries.
Chiropractic therapy Chiropractic therapy is based on moving parts of your spine to ease pain and help you feel better.
Herbal products and dietary supplements These products are found in nature and include garlic, ginkgo, ginseng and St John's Wort. Although they occur in nature, some of the chemicals within them can cause side effects or interact with conventional medicines.  
Homeopathy Homeopathy uses highly diluted substances, which are shaken vigorously. Practitioners claim that these can cause your body to heal itself.
Massage Massage is used to help circulation (blood flow), ease tension (loosen tight muscles) and lower stress.
Osteopathy Osteopathy involves gently moving your bones and muscles to ease pain and help you feel better.

Rongoā  Māori
(traditional Māori healing)

Rongoā Māori is an important part of healthcare for many Māori and is based on a holistic approach to health. It includes native plant-based remedies, physical therapies and spiritual healing.

In New Zealand, the Accident and Compensation Corporation (ACC) funds acupuncture, chiropractic manipulation and osteopathy.

Does CAM work?

Many alternative treatments seem to work, but whether this is due to an actual clinical effect or belief that it will work (called the placebo effect – see below), is undecided. Conventional medicines undergo rigorous testing and must show safety and benefit before they are made available for public use. While in use, they continue to be tested to check if any harms occur. If any harms outweigh the benefits, then the medicine is withdrawn from the market. It is difficult to use scientific methods to check whether CAM has made a difference – only a few high quality studies of alternative therapies exist. 

The placebo effect

The placebo effect is a remarkable phenomenon in which a placebo – a fake treatment such a sugar or saline solution – leads to improvement in a person's condition simply because the person has the expectation that it will be helpful. Likewise, when the belief in the value of an alternative therapy is strong, this can account for the success of a treatment even if scientifically it may not be accepted. 

Other factors may lead to the success of CAMs, such as the following:   

  • People may get better due to the natural course of an illness and think this could be due to their alternative therapy.
  • Many illnesses are cyclical and people often seek alternative therapy when symptoms are at their worst. When symptoms improve, this is attributed to the therapy.
  • An alternative therapy may be tried after conventional medical treatment and when symptoms improve, it is attributed to the new therapy rather than the medical treatment.
  • If the original diagnosis is wrong, then claims of a cure are meaningless.
  • The time and attention from the provider of alternative therapy may improve wellbeing.
  • Alternative therapies may help to give hope.

Safety concerns

Herbal or natural products and dietary supplements are not always safe and may have safety concerns. In New Zealand, Medsafe often reports adverse effects and interactions associated with herbal products and dietary supplements.

Considerations if you are using CAM

If you are using CAM, let your doctor know. Together you can discuss any benefits of using CAM and check interactions with your conventional medicine or treatment and any safety concerns. For example, some plants can interact with conventional medicines. The sorts of questions that you and your doctor may want to discuss include the following:   

  • Is there clinical evidence of effect?
  • Is it expensive?
  • Are there adverse effects?
  • Does it interact with other medications?
  • Will it compromise conventional medical treatment?
  • Will it reduce the need for conventional medications?

You can check for warnings on natural and herbal products on the Medsafe website.

Learn more

Herbal supplements: What to know before you buy Mayo Clinic, US
Complementary and alternative medicine Cancer Society, NZ
Complementary and alternative medicine NHS, UK

References

  1. Traditional Chinese medicine practitioners in New Zealand – differences associated with being a practitioner in New Zealand compared to China NZ Medical Journal, 2016 
  2. Demystifying Rongoā Māori – traditional Māori healing BPAC, NZ, 2008
  3. Antioxidants and ageing – harmless placebo or dangerous to your health? BPAC, NZ, 2008
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 24 Sep 2017