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