Complementary and Alternative

Medicine

Dr Monem Alshok

2018

Complementary and Alternative

Medicine CAM Definitions

CAM is a group of diverse medical and

health care systems, practices, and products

that are not generally considered to be part

of conventional medicine.

Complementary and Alternative Medicine

Complementary medicine is used together with

conventional medicine.

Alternative medicine: is used in place of

conventional medicine. (e.g.) using special diet

to treat cancer instead of chemotherapy, surgery,

etc...or certain Herbs to treat DM

Integrative medicine : combines treatments from

conventional medicine and CAM for which there is

evidence of safety and effectiveness.

Alternative Medical Systems: Complete systems of

medical theory and practice. e.g. Homeopathic

Medicine , In homeopathic medicine, there is a belief

that "like cures like," meaning that small, highly

diluted quantities of medicinal substances are given

to cure symptoms, when the same substances given

at higher or more concentrated doses would actually

cause those symptoms.

Introduction to CAM

More than 30% of adults use complementary and

alternative therapies

Relieve problems

Promote wellness

No relief from traditional treatments

44-5

Roots of Nontraditional Therapies

Ancient Greece: massage, art therapy,

herbal therapy.

The Far East: energetic-touch therapies.

China: acupuncture, herbalism.

India: Ayurvedic medicine.

History of CAM :

25% of all pharmaceutical drugs are

derived from herbs.

Prior to 1990 little was known about who

was using CAM

1993 – study showed that 1 in 3 Americans

sought some form of alternative care 1997 –

another follow up study revealed that 47%

of Americans were using some form of

CAM

History

Ayurveda – 1500 BC to AD 500

Acupuncture – 5,000 years old

Traditional Chinese Medicine (TCM) – 2,000 years old

Homeopathy – 1790s

Types of CAM( 4 Main Domains of CAM

1 . Mind-Body Medicine : techniques designed to enhance the mind's capacity to

affect bodily function and symptoms ( e.g. ) meditation, mental healing

2 . Energy Medicine : therapies affecting “body energy fields” (qi gong, healing

touch, Reiki) or unconventional use of electro-magnetic fields using

3 . Manipulative and Body-based Practices : chiropractic or osteopathic

manipulation or massage therapy

4 . Biologically based products & Naturopathy : herbs and other dietary

supplements (Most commonly used type of CAM are dietary

supplements/herbs )

Manipulative and Body-Based Methods:Based on

the manipulation and/or movement of one or more

parts of the body .

Types:

Massage therapy

Chiropractic manipulation

Reflexology

Osteopathy

Massage: include Pressure, kneading, stroking, vibration, and tapping to positively affect health

What are the Effects of Massage Techniques :

1 . Relaxation

2 . Counteracts effects of stress

3 . Lowers heart rate and blood pressure

4 . Reduces pain / relaxes muscle spasms

5 . Improves concentration

6 . Promotes restful sleep

7 . Helps the mind relax

Chiropractic medicine

Adjustments by Manual treatments to re-align the

vertebra and restore function of spinal nerves.

Chiropractor : Performs an exam and takes a history

Tests: X-rays ,Muscle testing ,Analyzes posture

Naturopathic Medicine:

Proposes that there is a healing power in the body that

establishes, maintains, and restores health.

Practitioners work with the patient with a goal of

supporting this power, through treatments such as

nutrition and lifestyle counseling, dietary supplements,

medicinal plants, and exercise

There are six principles that form the basis of naturopathic practice:

The healing power of nature

Identification and treatment of the cause of disease

The concept of "first do no harm"

The doctor as teacher

Treatment of the whole person

Prevention

Naturopathy: include

1. Diet modification and nutritional supplements,

2 . Herbal medicine,

3 .Acupuncture and Traditional Chinese medicine,

4 . Hydrotherapy,

5 . Massage and joint manipulation The application

of controlled force to a joint, moving it beyond the

normal range of motion in an effort to aid in

restoring health.

In general we can said :

The Main complaints for which patients use CAM

include : Headache , Pains ,Anxiety , Back pain

,joint pain , Cancer , Gastrointestinal disorders or

sleeping problems

Who Uses CAM? In 2004 survey

results:

More women than men.

Higher education levels ,

Hospitalized in the past year .

Former smokers

Homeopathy:“In the late 1700s, Samuel Hahnemann, a physician, chemist, and linguist in Germany, proposed a new approach to treating illness.” Treatments of the time were harsh, and wanted a less threatening way to practice medicine. – “Like cures like”– Potentiating and holism.

“The World Health Organization noted in 1994 that homeopathy had been integrated into the national health care systems of numerous countries, including Germany, the United Kingdom, India, Pakistan, Sri Lanka, and Mexico.”

“In European countries, training in homeopathy is usually pursued either as a primary professional degree completed over 3 to 6 years or as postgraduate training for doctors.”

“In the United States, training in homeopathy is

offered through diploma programs, certificate

programs, short courses, and correspondence

courses. Also, homeopathic training is part of

medical education in naturopathy. Most homeopathy

in the United States is practiced along with another

health care practice for which the practitioner is

licensed, such as conventional medicine,

naturopathy, chiropractic, dentistry, acupuncture, or

veterinary medicine (homeopathy is used to treat

animals).”

What we mean by Manipulative and Body-Based

Methods ?

* Chiropractic medicine involves manipulative

techniques to correct abnormalities of spine &the

musculoskeletal system . Chiropractic Medicine -focuses

on the relationship between bodily structure (primarily

that of the spine) and function, and how that

relationship affects the preservation and restoration of

health. Chiropractors use manipulative therapy as an

integral treatment tool

* Osteopathic medicine: a medical field incorporating

manipulative techniques for correcting abnormalities of

musculoskeletal system . Osteopathic Medicine -emphasizes

diseases arising in the musculoskeletal system. There is an

underlying belief that all of the body's systems work together,

and disturbances in one system may affect function elsewhere

in the body. Osteopathic physicians practice osteopathic

manipulation, a full-body system of hands-on techniques to

alleviate pain, restore function, and promote health and

wellbeing

* Massage Therapy -manipulate muscle and connective tissue

to enhance function of those tissues and promote relaxation

and wellbeing

Energy Therapies :

Biofield Theories-affect energy fields that purportedly

surround and penetrate the human body

– Therapeutic Touch

– Healing Touch

– Reiki

– Quantum Healing

– Qi-Gong : Bioelectromagnetic Theories-unconventional use of electromagnetic fields.

– Magnetic Healing

– Radionics

What is Mind – Body Medicine ?

Mind/Body Therapy : Reviewed by Astin, et al. Concluded that there is considerable evidence that Mind – Body are beneficial:for:

– Coronary artery disease

– Headaches

– Insomnia

– Chronic low back pain

– Treatment related symptoms of cancer

The principle of this therapy is that :

Imagery is the biological connection between the mind and body. As

we will see, this is extremely useful in mind body healing.”

Techniques designed to enhance the mind's capacity to affect

bodily function and symptoms include :

• Meditation

• Prayer

• Mental Healing,

• Art, Music and Dance Therapy

Mind – Body Medicine is a type of CAM based on the Belief

that emotional, mental,social, spiritual, and behavioral

factors affect health . Respects and encourages individual’s

capacity for self knowledge and self-care. Techniques include

– Yoga or tai chi

– Relaxation therapies

– Cognitive & behavioral therapies

– Group support

– Meditation

– Creative arts therapy

Meditation

Quieting the mind by focusing the attention.

Benefits include: stress relief, relaxation, reduced level of lactic acid, efficient & effective oxygen consumption, slowed heart rate, decreased blood pressure, improved functioning of the immune system.

Bio-feedback

The measurement of physiological

responses that yields information about the

relationship between the body and mind and

helps clients learn ways to manipulate those

responses through mental activity.

Uses of Bio-feedback

A restorative method in rehabilitation settings for clients who have lost sensation and function as result of injury or illness.

To relieve tension headaches, migraines and backache.

To reduce bruxism (grinding of the teeth).

To lower blood pressure.

Temperature bio-feedback useful in treating Raynaud’sdisease (constriction and spasms of small arteries).

Therapeutic Hypnosis

Induces an altered state of consciousness or

awareness resembling sleep during which the

person is more receptive to suggestion.

Hypnosis also enhances client’s ability to form

images (for guided imagery).

What is Ayurveda?

• A comprehensive system of medicine developed in India that places equal emphasis on the body, mind, and spirit, and strives to restore innate harmony of the individual.

• Primary treatments include diet, exercise, meditation, herbs, massage, and controlled breathing.

Ayurveda, which literally means: "the science of life," is a natural healing system developed in India. Ayurvedictexts claim that the sages who developed India's original systems of meditation

Ayurveda is a conscious mental process using certain techniques

such as :

* Focusing attention or maintaining a specific posture -- to suspend

the stream of thoughts and relax the body and mind. and yoga

developed the foundations of this medical system.

* It is a comprehensive system of medicine that places equal

emphasis on the body, mind, and spirit, and strives to restore the

innate harmony of the individual.

* Some of the primary Ayurvedic treatments include diet, exercise,

meditation, herbs, massage, exposure to sunlight, and controlled

breathing.

In India, Ayurvedic treatments have been developed

for various diseases (e.g., diabetes, cardiovascular

conditions, and neurological disorders). However, a

survey of the Indian medical literature indicates that

the quality of the published clinical trials generally

falls short of contemporary methodological

standards with regard to criteria for randomization,

sample size, and adequate controls .

Traditional Chinese Medicine it is a type

of CAM based on the following :

• Health is achieved by maintaining the body in a "balanced state”.

• Imbalance leads to blockage in the flow of qi.Energy which flow in the body in certain Meridians

• CAM practioners typically use herbs, acupuncture, and massage to help unblock qi in an attempt to bring the body back into harmony and wellness

Traditional Chinese Medicine

TCM :

TCM based on a concept of balanced qi, or vital energy, that is believed to flow throughout the body. Qi is proposed to regulate a person's spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of yin (negative energy) and yang (positive energy). Disease is proposed to result from the flow of qibeing disrupted and yin and yang becoming imbalanced

Acupuncture:

is one type of traditional chinnes

Medicine through which they use of

insertion of Hair – Thin needles into a

non – anatomic energy channels called

Meridians .

There are three main therapeutic modalities:

1 . Acupuncture and moxibustion In traditional Chinese medicine, the use of heat from burning the herb moxa on or near the skin at an acupuncture point. Intended to stimulate the flow of qi and restore health. (moxibustion is the application of heat from the burning of the herb A plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. moxa at the acupuncture point)2 . Chinese Materia Medica is a standard reference book of information on medicinal substances that are used in Chinese herbal medicine. 3 . Massage and manipulation

TCM is a complete system of healing that

dates back to 200 B.C. in written form. Korea,

Japan, and Vietnam have all developed their

own unique versions of traditional medicine

based on practices originating in China.

In the TCM view: The body is a delicate balance of two

opposing and inseparable forces: yin and yang . The

concept of two opposing yet complementary forces

described in traditional Chinese medicine. Yin represents

cold, slow, or passive aspects of the person, while yang

represents hot, excited, or active aspects. A major theory is

that health is achieved through balancing yin and yang

and disease is caused by an imbalance leading to a

blockage in the flow of qi..

Among the major assumptions in TCM are that health is

achieved by maintaining the body in a "balanced state"

and that disease is due to an internal imbalance of yin

and yang. This imbalance leads to blockage in the flow of

qi . In traditional Chinese medicine, the vital energy or

life force proposed to regulate a person's spiritual,

emotional, mental, and physical health and to be

influenced by the opposing forces of yin and yang. (or

vital energy) and of blood along pathways known as

meridians. TCM practitioners typically use herbs,

acupuncture.

Treatments in TCM : are typically tailored to

the subtle patterns of disharmony in each

patient and are based on an individualized

diagnosis. The diagnostic tools differ from

those of conventional medicine

Herbs

Herbs : definition

When a plants or products made

from them , can have a powerful

impact on our bodies and when

plants are used for such effects

rather than as food , they are

called Herbs

Examples of some Useful Herbal Products

Echinacea immune stimulant

Saw Palmetto BPH

Ginkgo circulation

Milk Thistle liver

Ginger nausea

Chamomile indigestion

Fever Few migraine

St. John’s Wort mild/mod depression

Hawthorn heart/circulation

Soy menopause symptoms

Kava anxiolytic

Black cohosh menopause symptoms

Green tea stimulant (antioxidant)

Cranberry UTI prevention

Yohimbe erectile dysfunction

Valerian Sleep Disorders

Garlic Hyperlipidemia

Challenges of Herbal Medicines &

Adverse effects:

Safety is assumed, not proven e.g Cabbage causes goiter ,some plants are poisonous ( Herb Tea )

Lack of product standardization

Contamination with drugs, heavy metals

Allergic reactions

Inherent toxicity

Interactions with drug

Replacing proven therapies

Complementary and Alternative

Medicine Garlic

•Decreases platelet aggregation over a period of 3-7 days

•Bacterialcidal but no evidence of an effect on viruses or fungi

•Fights Salmonella and staph

•Terpenoid effect- membrane disruption

•Essential oil

•has determined it has cancer defending properties

Probiotics: definitions

“live microorganisms which when administered in adequate amounts

confer a health benefit on the host”e.g. Lactobacillus sp.

Sources: breastmilk, barley, bran and whole grains, legumes, such as

beans; vegetables such as leeks, onions, asparagus, greens such as

chicory, spinach, burdock, fruits such as bananas, berries

Doses: 1 – 2 grams daily (adults)

Side effects: flatulence, diarrhea, allergies