Alternative Therapies: Benefits and Risks
In a world where the use of many prescription drugs and medical procedures are at an all-time high, people are seeking
alternatives to conventional medicine. Alternative therapies refer to treatments that have not been scientifically tested for
effectiveness, or whose effectiveness has not been shown despite scientific testing.1
In the United States, many alternative therapies are used as complementary medicine. That is, rather than taking the place
of traditional medicine, they are used to complement those approaches, sometimes thought to boost efficacy and reduce side
effects of traditional medicine and approaches.
Many alternative therapies have their origin in Eastern tradition, such as Traditional Chinese Medicine (TCM).
TCM practitioners use a combination of herbal remedies and mind-body practices, such as acupuncture, to treat and prevent
health issues. TCM is not the only source of alternative therapies. Chiropractic medicine, aromatherapy, biofeedback,
homeopathy, meditation, Reiki, and yoga are all considered complementary or alternative therapies.2
Whether it’s chronic back pain, insomnia, difficulty losing weight, or a host of other complaints, proponents of
alternative therapies suggest conventional medicine may not always be necessary or enough, and in some cases may not even be
as beneficial as alternative therapies.
Chiropractic Medicine
Back pain and migraines are two of the most common reasons people start seeing a chiropractor. They are also two of the
ailments most likely to lead to chronic medication use in conventional medicine. The promise of not needing to take
medication for pain is quite alluring to many long-time sufferers.
Chiropractic medicine was invented in 1895 when D. D. Palmer adjusted the spine of a deaf man and allegedly restored his hearing.3 Based on this, Palmer theorized that all disease is caused by slight misalignments in the vertebrae, called
subluxations. From this he suggested that manipulating the spine replaces the bones, removing the nerve interference and
restoring health.
Some research does exist to show that spinal manipulation therapy (SMT), like chiropractic medicine, may be beneficial for
those with low back pain, but it has not been shown to be any better than other methods to treat low back pain. SMT is also
not limited to chiropractic medicine and may be performed by physical therapists and doctors of osteopathy.
Regular patients of chiropractic medicine report better sleep, reduced pain, and reduced stress from spinal manipulation. Aside from the limited results with chronic low back pain, there is no research to support these claims.
According to some reports, up to half of patients report short-term negative effects from spinal manipulation. These may
include increased local or radiating pain or (rarely) an injury to the vertebrobasilar arteries that may cause stroke,
paralysis, and death.
Recently, the death of model Katie May was attributed by the coroner to a stroke that occurred when a visit to the
chiropractor ruptured an artery in her neck.4 While incidents like this are rare, it is important to understand the risks
alongside the potential benefits before seeing a chiropractor.
Acupuncture
Stress, on the other hand, is the number one reason people try acupuncture. For many, the idea that acupuncture might
decrease stress levels is reason enough to give it a try. After all, who doesn’t have high stress in this day and age? Also,
among the top reasons people try acupuncture are Fibromyalgia pain, smoking cessation, fertility concerns, food
cravings/weight loss, and anxiety/depression.
Acupuncture is a technique in which practitioners stimulate specific points on the body by inserting thin needles
through the skin.
According to the traditional theory, energy (qi - pronounced “chi”) flows through the body in channels referred to as meridians.5 These channels are thought to be connected to all of the major organs in the body. When energy is disrupted,
there are issues with the associated organs. By inserting needles into the skin aligned with particular meridians, the
flow of Qi is believed to be restored, resulting in improved health.
Some studies suggest that acupuncture may help ease chronic low -back pain and neck pain as well as reducing the
frequency of tension headaches and preventing migraines. In general, research on acupuncture has shown a strong placebo
effect. In these studies, “sham” acupuncture has been applied to participants. Sham acupuncture may take the form of
actually inserting acupuncture needles into the skin, but in the “wrong” places, or it may involve only the sensation of
touch resembling that in true acupuncture, but without any puncturing of the skin.6
These studies have found that sham acupuncture (placebo) is just as effective as real acupuncture when it comes to
patient-reported effects.
In general, acupuncture is considered safe when provided by a trained professional. The most common negative effects
occur when needles are not properly sterilized or inserted, including skin infection.
Cupping
Similar to acupuncture, cupping is an alternative therapy that has been around for a long time, but which you may have
only heard about recently. After several Olympic athletes were seen with circular marks on their bodies, attributed to
cupping that reportedly helped boost athletic performance in a variety of ways, interest in cupping has increased. People
get cupping for many reasons including decreasing pain and inflammation, increasing blood flow, and for relaxation.
By using cups to create suction (either through heat or through automated pumps) on the surface of the skin, blood flow
is directed to the area under suction. Depending on how long the cups remain on the skin, capillaries may burst, resulting
in discoloration and bruising.7
The suctioning also affects the soft tissue of the body. According to proponents of cupping, this decompresses the
myofascial tissue and decreases the lesions in the tissue. If this sounds similar to what you may have read about foam
rolling and self-myofascial release (SMFR), that’s because it is. Decreasing the lesions in the fascia is thought to help
in the treatment of many injuries, including plantar fasciitis and muscle strains.
While most athletes appear to receive dry cupping (based solely on suction) another form of cupping referred to as wet
cupping, also exists. In this type of cupping, the cup is removed after suction and a scalpel is used to make a small
incision in the skin. A second suction is then used to remove a small amount of blood. Like other forms of bloodletting,
there is no research to support its effectiveness.
Common side effects of cupping include bruising, burns, and skin infection. Excessive wet cupping can also lead to
anemia.8
Other Alternative Therapies
While chiropractic medicine, acupuncture, and cupping all require physical manipulation or stimulation, there are
several minimal-touch and no-touch alternative therapies, including yoga, Reiki, and herbal medicine.
Yoga
In today’s Western society, yoga is often thought of as a way to increase overall wellness rather than as a treatment
or therapy. While some people engage in yoga strictly for exercise purposes, the origin of yoga is as a mind-body therapy
to reduce stress and restore the flow of energy through the meridians (similar to acupuncture). The specific poses are
thought to restore energy flow through particular meridians, thereby helping with particular ailments.
While there is research to suggest yoga has beneficial effects on reducing stress, many believe this can be attributed
to the general effects of exercise. Similar effects have been shown by cardiovascular exercise, general stretching, and
walking.
The risks of yoga are minimal and are primarily the result of engaging in poses that are too difficult for an
individual’s current capacity. This can lead to muscle strains, falls, and pinched nerves.
Reiki
Reiki is another alternative therapy that, while including touch, does not include any physical manipulation. It is a
healing technique based on the idea that the therapist, or Reiki practitioner, can channel energy into the patient by
means of light touch, to activate the natural healing processes of the patient's body and restore physical and emotional
well-being. This is also based on the idea of energy flow (qi) as a primary means of healing the body. One can become a
Reiki practitioner by taking training classes, but this practice is otherwise unregulated.
Clinical research has not shown Reiki to be effective as a medical treatment for any medical condition.
Herbal Medicine
The use of herbal medicine is arguably one of the most accepted forms of alternative therapy in the Western world.
Just about everyone knows someone who has taken Echinacea in hopes of avoiding a cold or has heard of St. John’s Wort as a
natural antidepressant. Recently, the World Health Organization estimated that 80% of people worldwide rely on herbal
medicines for some part of their primary health care.
The use of herbal medicine is also one of the most easily studied alternative therapies due to the ease of conducting
placebo-controlled research.
While some herbal medicines, such as St. John’s Wort,9 have shown to be effective in treating certain ailments or
in boosting the immune system, herbal medicine is not routinely tested and regulated like traditional medicine.10
This means that even if a particular herb has been shown to be beneficial, different brands of herbal supplements may
contain differing quantities of the active ingredient. Because they are not regulated, you may be spending money on
supplements that don’t have enough of the herb to work and may also contain other ingredients that may be unhelpful or
potentially dangerous.
Another concern is the interaction of herbs. Many herbs can interact with prescription medications as well as with each
other. In these cases, the use of the herbs may actually worsen a medical condition rather than improve it.
This is why it is important to share all medications you are taking with your doctor, whether they are herbal, over the
counter, or prescription.
So, Does it Work?
By definition, alternative therapies have not been proven to work by the scientific method. The studies that do exist
have been criticized for researcher bias and for issues in research design. Take, for example, chiropractic medicine in
which a double-blind study (in which neither the participants nor the researchers know who is receiving treatment and who
isn’t) would not be possible.
Proponents of alternative and complementary medicine exist in two camps. On one side are those who believe that
alternative and complementary medicine really do work just as well or better than traditional medicine, despite the lack
of scientific evidence. On the other side are those who suggest that even if the effect is placebo, what is the harm in a
placebo that makes people feel better?
There is controversy surrounding the use of placebos to treat diseases, which is why it is currently considered
unethical to prescribe sugar pills to a patient. There are doctors, however, who prescribe sub-therapeutic doses of
medications, meaning those that are too low to actually be effective, to produce a placebo effect in patients.
When it comes to alternative therapies, there are no guiding ethical boards. It is up to each individual to make a
choice about his or her own health and use of alternative therapies. The official stance of many organizations and doctors,
is that using these therapies as an alternative to scientifically proven treatments is not advisable, particularly in
cases of potentially fatal diseases and conditions. Use of these therapies as a complement to traditional therapies and
medication is something that should be discussed between patients and their doctors or nurses.
Sources
- National Science Board (2002). "Chapter 7: Science and Technology: Public Attitudes and Public Understanding, Section: Belief in Alternative Medicine". Science and Engineering Indicators - 2002. Arlington, Virginia: Division of Science Resources Statistics, National Science Foundation, US Government.
- Johns Hopkins Health Library: http://www.hopkinsmedicine.org/healthlibrary/conditions/complementary_and_alternative_medicine/types_of_complementary_and_alternative_medicine_85,P00189/
- Ernst E (May 2008). "Chiropractic: a critical evaluation". Journal of pain and symptom management. 35 (5): 544–62.
- Adams, Char. "Playboy Model Katie May Died After Chiropractor Ruptured an Artery in Her Neck, Coroner Says". People Online. Retrieved 30 October 2016.
- Academy of Classical Oriental Sciences. “The Chinese Medicine Meridian System”. ACOS.org. Retrieved 29 October 2016
- Lund, I., & Lundeberg, T. (2006). Are minimal, superficial or sham acupuncture procedures acceptable as inert placebo controls?. Acupuncture in Medicine, 24(1), 13-15.
- Tham, L. M., Lee, H. P., & Lu, C. (2006). Cupping: from a biomechanical perspective. Journal of biomechanics, 39(12), 2183-2193.
- Lee, H. J., Park, N. H., Yun, H. J., Kim, S., & Jo, D. Y. (2008). Cupping therapy-induced iron deficiency anemia in a healthy man. The American journal of medicine, 121(8), e5-e6.
- Linde, K., Ramirez, G., Mulrow, C. D., Pauls, A., Weidenhammer, W., & Melchart, D. (1996). St John's wort for depression—an overview and meta-analysis of randomised clinical trials. Bmj, 313(7052), 253-258.
- Bent, S. (2008). Herbal medicine in the United States: review of efficacy, safety, and regulation. Journal of general internal medicine, 23(6), 854-859.
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