If people think that alternative medicine is rubbish because it has not undergone bench mark trials than I say, stop eating because true 'alternative medicine' has been around for centuries, is mostly food based and many of our pharmacueticals are based on 'alternative medicines' eg lipator.

Please provide some evidence to support your claim that "alternative" medicine has been successful at anything other than taking money from the least knowledgeable.

.

Dear Tim Noonan,

I appreciate your request. I asked the question and do not fully agree with the complementary and alternative medicine (CAM). although CAM is the term for medical products and practices that are not part of standard care, it is used together with standard medical care as integrative medicine or integrative health. it is the combination of the practices and methods of alternative medicine with conventional medicine.( Peking University Health Science Center (formerly Beijing Medical University) was the first of the kind in China to teach western medicine and train medical professionals). An example is using acupuncture to help with side effects of cancer treatment.

People with cancer may use CAM to

• Help cope with the side effects of cancer treatments

• Ease worries of cancer treatment and related stress

• Feel that they are doing something more to help their own care

I am not with the alternative medicine but with both in some cases and here are few research articles:

Bialosky JE, George SZ, Horn ME, at al. Spinal manipulative therapy-specific changes in pain sensitivity in individuals with low back pain (NCT01168999). The Journal of Pain. 2014;15(2):136–148.

Jedel S, Hoffman A, Merriman P, et al. A randomized controlled trial of mindfulness-based stress reduction to prevent flare-up in patients with inactive ulcerative colitis. Digestion. 2014;89:142–155.

I do not see a benefit from the "alternative" medicine treatment for low back pain.

There was a statistically significant difference in satisfaction favoring the enhanced placebo group, which suggests that the benefit is related to how well the idea is sold to the patients.

Spinal manipulative therapy-specific changes in pain sensitivity in individuals with low back pain

"Participant Satisfaction

Significant group-related differences were observed in response to the question “Would you have the same intervention you received in this study again for low back pain?” χ2(3, n = 106) = 8.15, P = .04 ( Table 5). Significantly more participants receiving the enhanced placebo SMT indicated “probably to definitely yes” than the other groups individually (P < .05). Significant group-related differences were observed in response to the question “How would you rate the overall results of the intervention you received in this study for low back pain?” Significantly more participants receiving the enhanced placebo SMT indicated “good to excellent” than participants receiving the standard placebo SMT or no treatment (P < .05). A significant difference was not observed between participants receiving the SMT and the enhanced placebo SMT (P = .07)."

-

The other paper looks at reducing stress to help ulcerative colitis. This is not news or "alternative" medicine.

Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission.

Levenstein S, Prantera C, Varvo V, Scribano ML, Andreoli A, Luzi C, Arcà M, Berto E, Milite G, Marcheggiano A.

Am J Gastroenterol. 2000 May;95(5):1213-20.

PMID: 10811330 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/10811330

Psychological stress and disease activity in ulcerative colitis: a multidimensional cross-sectional study.

Levenstein S, Prantera C, Varvo V, Scribano ML, Berto E, Andreoli A, Luzi C.

Am J Gastroenterol. 1994 Aug;89(8):1219-25.

PMID: 8053438 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/8053438

Why is stress reduction for ulcerative colitis being presented as "alternative" medicine?

.

In regards to low back pain a significant number of patients benefit from higher levels of vitamin D. Idiopathic low back pain is often the first sign of low vitamin D levels or osteomalacia. Correction with 4000IU (not the usual 400 or 800 suggested ) of vitamin D often corrects this and I have seen some astonishing results in my practice.

http://www.jabfm.org/cgi/reprint/22/1/69

The knowledge related to conventional medicines are passed from one generation to the next by words. Many of these medicines are not documented. How to identify plant species, which plant part is medicinally important, how to prepare the formulation, what are the doses. These are some of the questions associated with some conventional medicines. However, many plant species are being successfully used by the people in different parts of the world to take care of health related problems. But this knowledge needs documentation, so that it can be conserved for the generations to come and to support them by scientific evaluation.

Regards

Gerry Schwalfenberg,

A case series is nice, but hardly persuasive.

Provide a randomized placebo controlled trial.

There are plenty of people with low back pain who could benefit if this treatment really does work, but I don't see any valid evidence.

Until there is valid evidence, there is not good reason to endanger patients with untested treatments.

.

Greetings Tim Noonan (and others)

I agree that there is need for much more research regarding complementary and alternative medicine (CAM), be it used for back pain or other chronic health care conditions. The literature provides strong support that a growing number of people of all ages are using CAM practices (so, we ought not simply ignore CAM altogether). The College of Physicians and Surgeons of Ontario recognize this - see: (http://www.cpso.on.ca/policies-publications/policy/complementary-alternative-medicine). All health care interventions have limitations. Both the consumer and the health care provider need to come to understand what these potential limitations / contraindications are. My training in Medical Sociology and Community Health (via the University of Toronto) have led me to explore this interesting and dynamic field. Examples include:

[-] Willison K.D., Lindsay S., Taylor M., Schroeder H., Andrews G. Complementary and Integrative Medicine, Aging and Chronic Illness: Towards an Interprofessional Approach in Primary Health Care. Chapter Two of: Adams J, Magin P, Broom A. (Editors) Primary Health Care and Complementary and Alternative Medicine - Research and Practice. London: Imperial College Press. Pages 35-50. 2013. ISBN: 978-1-84816-977-7

URL: http://www.worldscientific.com/worldscibooks/10.1142/p875

[-] Willison, K.D. (2008). Advancing Integrative Medicine through Interprofessional Education (IPE). The International Journal of Health Sociology: Policy, Promotion, Equity and Practice. Special Issue. Health Sociology Review 17(4): 342-353.

[-] Willison, K.D., Williams, P., Andrews, G.J. (2007). Enhancing Chronic Disease Management: A Review of Key Issues and Strategies. Journal of Complementary Therapies in Clinical Practice 13:232-239. http://dx.doi.org/10.1016/j.ctcp.2007.06.002

[-] Willison, K.D. (2007). Assessing Chronic Disease Management Strategies Through Community Based Participatory Research. Journal of Chinese Clinical Medicine, June, Vol. 2 (6):336-340. http://old.cjmed.net/html/2007626_107.html

[-] Willison, K.D. (2006). Integrating Swedish Massage Therapy With Primary Health Care Initiatives As Part Of A Holistic Nursing Approach. Complementary Therapies in Medicine; December, 14 (4): 254-260.

URL: http://www.ncbi.nlm.nih.gov/pubmed/17105695?dopt=Abstract

[-] Willison, K.D. (2005). Integrating complementary and alternative medicine into primary healthcare in Canada: Barriers and opportunities. Journal of Cancer Integrative Medicine; 3(2):71-74.

[-] Willison, K.D., Andrews, G.J., Cockerham, W.C. (2005). Life Chance Characteristics of Older Swedish Massage Therapy Users and Former Users. Journal of Complementary Therapies in Clinical Practice; November, 11 (4):232-241. http://dx.doi.org/10.1016/j.ctcp.2004.10.003

[-] Willison, K.D., Mitmaker, L., Andrews, G.J. (2005). Integrating Complementary and Alternative Medicine with Primary Health Care through Public Health to Improve Chronic Disease Management. Journal of Complementary and Integrative Medicine; 2(1) – Article 2. The Berkeley Electronic Press. http://www.bepress.com/jcim/vol2/iss1/2, DOI: 10.2202/1553-3840.1012

[-] Willison, K.D., Andrews, G.J. (2004). Complementary Medicine and Older People: Past Research and Future Directions. Complementary Therapies in Nursing and Midwifery, 10 (2): 80-91. URL: http://dx.doi.org/10.1016/S1353-6117(03)00106-9

Kevin Willison,

Those seem to be articles that are about how to promote the use of CAM.

The problem with CAM is that it does not work.

We have spent billions of dollars on the National Center for Complementary and Alternative Medicine and the results consistently show that CAM is just another over-priced placebo.

We should be studying ways to discourage people from wasting their money.

If you disagree, please provide valid evidence that "alternative" medicine works.

.

No doubt that a scientific argument still exist between research articles. Pros and Cons are there. If certain percentage of people still see benefits of such treatment over the other you cant stop them of relying on what they see is good for them. Many of them have had bad experiences from the conventional medicine as well. Debate of this issue open a challenging research.

Hashem Kilani,

There are many problems with conventional medicine using treatments that are not based on evidence of improved outcomes.

The solution is to eliminate these treatments, not to lower standards so that we use more treatments that do not work.

If a treatment does not work, it exposes patients to risks that are not necessary and probably are not known.

We should be protecting patients from treatments that do not work, regardless of whether the treatments are called conventional, alternative, or complementary.

.

If people think that alternative medicine is rubbish because it has not undergone bench mark trials than I say, stop eating because true 'alternative medicine' has been around for centuries, is mostly food based and many of our pharmacueticals are based on 'alternative medicines' eg lipator.

i absolutely agree. Many of my clients are on a litany of pharmacueticals and they have no idea why they are on them...this is not medicine, it s is band aides on top of band aides. I have also noted many conventional doctors are quick to diagnose psychological pathoogies eg have a look at the literature on fibromyalgia and recommended treatments...

It appears when an aetiology is not recognisable then 'it must be psychological' this is not appropriate and not medicine.

True alternative medicine is anything that is not medicine.

We eat to satisfy nutritional requirements.

We appear to take alternative medicine because we don't understand the difference between wishful thinking efficacious.

Too much of conventional medicine is as bad as alternative medicine - it has been around for a long time, but still has no evidence of any benefit to anyone who is not making a profit off of the customers.

We need to raise our standards to keep dangerous treatments out, not lower our standards to let more dangerous treatments in.

:-)

I think Tim underestimates the public. In my experience those that turn to 'alternative medicine' do so because they have been harmed and or are frustrated by the inability of 'conventional medicine' to cure. 96% of conventional medicine is palliative, and I mean palliative in its truest sense, not its misuse as a treatment for end of life. Eg. Take blood transfusion for those with sickle cell anaemia, this is palliative treatment because the treatment does NOT cure. To your comment about we eat to satisfy our nutritional requirements, food is more than nutrition. It cleanses, detoxifies, nourishes the body and mind, it soothes our senses and souls. As I said in another post, do not forget that much conventional pharmaceuticals are plant and animal based....an extension of food. If we look at food chemically we can work out why it works for certain illness, eg the humble chicken soup. As for your comment about keeping dangerous treatments out, do you include pharmaceuticals? eg look at how harmful macrolides are, chemotherapy how effective is it really? Look at the n points in research and you will see that much has changed since the 60's in cancer treatment in regard to morbidity and co-morbidities.

Hippocrates said 'let food be your first medicine'

If you have some valid evidence on food to "detoxify," please provide it.

"Look at the n points in research and you will see that much has changed since the 60's in cancer treatment in regard to morbidity and co-morbidities."

Please provide some information to clarify what you are referring to.

"As for your comment about keeping dangerous treatments out, do you include pharmaceuticals?"

I include everything that does not have evidence of safety and efficacy - efficacy of improved outcomes that matter, not just surrogate endpoint outcomes.

I hold alternative medicine to the same standard, but there does not appear to be anything of benefit to patients from alternative medicine.

If eating a healthy diet keeps you away from the doctor, then that is a good thing. If you end up with a serious illness in spite of a healthy diet, or because of a diet that "detoxifies," then you may need real medicine rather than platitudes.

.

detoxify is a very misused term....bowel and urine evacuation are part of the detoxifying

process as is the exchange of gases, balancing of electrolytes etc. Your comment about evidence of safety and efficacy is only ever substantiated after decades of use, rather than months. Eg desferrioxamine has been around for about 48 years as an iron chelator, I would consider that safe and effective (not withstanding, as with all drugs there can be side effects). Then we go to the newer drugs like marolides which are proving extremely deleterious in fact have caused heart attacks: see Ann Fam Med. 2014;12(2):121-127. I could go on, but I think it is incumbent upon all of us to be open minded and not follow slavishly. We need to use what works, and saying a treatment does not work because it is a CAM is not an accurate statement.Most conventional treatments have never been bench marked eg blood transfusions, hip replacements, cardiac surgery.

"Eg desferrioxamine has been around for about 48 years as an iron chelator, I would consider that safe and effective (not withstanding, as with all drugs there can be side effects)."

That is not evidence of safety or efficacy.

Please provide some valid evidence.

The macrolide antibiotics have been around for decades, which would be evidence of safety and efficacy according to your earlier mentioned standard.

I have been critical of the rampant use of antibiotics, but they remain popular. The side effects are not really new.

This is why we need to have high standards for evidence. Too many treatments are used without good evidence that the treatment is better than a similar drug with a better safety profile.

Again, we need to raise our standards, not lower them.

"I could go on, but I think it is incumbent upon all of us to be open minded and not follow slavishly."

Why should we open our minds - if that means endangering our patients with treatments that are not safe and do not work?

"We need to use what works, and saying a treatment does not work because it is a CAM is not an accurate statement."

Here is what I wrote. If you want to quote me, go ahead, but do not make up statements that I did not make.

"I include everything that does not have evidence of safety and efficacy - efficacy of improved outcomes that matter, not just surrogate endpoint outcomes.

I hold alternative medicine to the same standard, but there does not appear to be anything of benefit to patients from alternative medicine."

CAM is not useless because it is CAM, it is useless because there is no evidence that it works. Provide valid evidence and I will change my mind about any particular treatment that has valid evidence that it improves outcomes.

If we cannot have an honest discussion among ourselves, how can our patients expect us to be honest with them?

:-)

I practice alternative medicine therapies and even ancestral knowledge in my area (Andes-Bolivia). When I see some comments I imagine that you see for alternative medicine in only one view. Make alternative medicine is to be holistic, who practices alternative medicine should also use conventional medicine, if not do it then goes for going astray, both are complementary, conventional medicine treats the causes of diseases from physicality to other aspects, alternative medicine manage other aspects apart from the physical, focuses more on the spiritual, psychological, energetic, emotional conventional medicine untreated and that is why it is often accused of metaphysics (paranormal things) then there no scientific proofs to support those facts. How many people with cancer, drug addicts, alcoholics, much psychological stress problems end up turning to alternative medicine ?. ¿Maybe a Hindu could give more examples ?.

Now people around the world are looking for natural things. This is not to say that conventional medicine is bad, that I agree with it.

More analysis needs to try alternative medicine

I think both should be one Conventional Medicine-Alternative Medicine, because at the end they watch for your health.

I am sure that in the future many things that are used in alternative medicine will be made fully tested. As already has been proving certain facts.

Dear Prof. Gonzales, I think you wanted to mean the traditional medicines used by the ethnic community, right? If so, in our hindu community in Bangladesh, other non-muslim communities like chakma, buddist etc also have their tradition to use some conventional medicine on the occasion religious festival. Usually, in the spring, when the summer season starts there cause different physical problem, like cough, measles, chicken pox cough, etc. In case of children hookworms are the major concern. Different traditional medicine here I can mention to be fruitfully used for these diseases. Neem leaf ( Azadirachta indica) as fried on little cooking oil used as food. Leaf extract in boiled water is used for different dermatological infection. Leaf extract of Glycosmis arborea and young leaf extract of pineapple leaves, root extract of spiny amaranthus are used commonly in the spring season to keep the children free from different diseases. Fresh pest of cucurmin (curcuma domestica) with other different wild plant, seed extracts are used to keep skin free of infection. 

So these medicines are yest used commonly in our hindu , buddist community as religious and social tradition. I support you in the aspect that these medicines will have no exception.

Particularly, in bangladesh, Indian subcontinent these conventional medicines are highly fabourble in the community.

Besides, there are many tid-bits of traditional medicine in the ethnic community. The experts on these medicines are usually called BOIDDYO. These system of medicinal treatment are termed as AYURVEDIC MEDICINE.

Here I give a link http://www.ayurveda-herbs.com/

you can find more similar conventional or traditional or Ayurvedic medicinal websites.

Hope I could add little to your asking. If yes, I would be glad.

Best regards

Thanks Dr. Partha Pratim Dhar, yes I tried to mean that a lot of traditional knowledge are inside of alternative medicine, so they are a lot of applications like Dr Partha mentioned; they are very useful, the problem is that a lot of people dont like this type of medicine because they are not proved scientifically, how ever they are a lot of new publications that are proving this facts, we scientists must try to help in this topics.

I am aware that in many cases the knowledge of alternative medicine have been misrepresented, used only for trade and deceit and also for illegal things. It is a difficult task trying to keep the original knowledge that many cultures that left, most of this knowledge is dying with their carriers ancestors who had 80-100 years old.

At this point I dare say that it is possible to mention that many people when they hear about alternative medicine only comes to their minds facts unconvincing, because the most part of the information is already infected, to the point that people believe in such superstitions.

Another reason why many of knowledge of alternative medicine is not demonstrated is by the difficulty you have when making experiments or controlling the confounding factors in the observations.

Then the task is to separate objectively all knowledge that show significant solutions and their real applications, but often involves taking a multivariate analysis and even a lot of protocols sustain that the essence of the expression of the fact it is on non physical (touchable) variables (subjective) and non counting this facts could affect the experiment (or observation) (For example the problem with the Masaru Emoto experiments ). To the other hand we must to correct the distorted knowledge.

There are already people working on this topic, even objectively trying to improve the reputation of alternative medicine.

A strong example in the application of alternative medicine is the effect of the moon on living organisms through its gravitational field, as this example there are others.