Wisdom Wednesday: Complementary and Alternative Medicine

People have used complementary and alternative medicine (CAM) practices for thousands of years in pursuit of health and well-being. However, rigorous, well-designed clinical trials for many CAM therapies are often lacking; therefore, the safety and effectiveness of many CAM therapies are uncertain. The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring research designed to fill this knowledge gap by building a scientific evidence base about CAM therapies - whether they are safe, whether they work for the conditions for which people use them and, if so, how they work.

Millions of American use CAM for health concerns and general wellness and spend tens of billions of dollars each year on such care. The 2007 National Health Interview Survey found that 38% of adults and 12% of children had used CAM in some form during the 12 months prior to the survey. The survey also revealed that Americans spent $33.9 billion out-of-pocket on CAM practices and products.

In 1999, NCCAM was established as the arm of the HIH to rigorously evaluate the safety and efficacy of CAM therapies, train researchers to conduct CAM research, and provide information to the public and health care professionals. Since its inception, NCCAM has funded more than 2,500 research projects to learn about how CAM therapies work as well as their safety and efficacy.

Studies have shown that spinal manipulation can provide mild-to-moderate relief from low-back pain and appears to be as effective as conventional medical treatments. Results from one trial that examined long-term effects in more than 600 people with low-back pain suggest that chiropractic care involving spinal manipulation is at least as effective as conventional medical care for up to 18 months.

In one of the largest clinical trials to date to test the safety and efficacy of acupuncture, NIH-supported researchers found that acupuncture significantly reduced pain associated with osteoarthritis of the knee when used as a complement to conventional therapy. Other studies and reviews demonstrated that acupuncture provides relief for vomiting and nausea from chemotherapy, shows possible effect for tension headaches, and that acupuncture and simulated acupuncture can both provide relief for those suffering from low-back pain.



Results from a long-term NIH-supported study revealed that people who took the dietary supplements glucosamine and chondroitin for osteoarthritis of the knee had outcomes similar to those experienced by people who took the drug celecoxib or placebo.

People with fibromyalgia may benefit from practicing tai chi according to a study in 66 people.

NIH is poised to make major discoveries in understanding CAM therapies and to use this information to expand the horizons of health care. There is limited information about the safety of many natural products, including data about toxicity or interactions with drugs or other natural products. Through the CAM research supported by NIH, Americans will have the scientific evidence they need to support the integration of a variety of CAM therapies into conventional medical settings.

My Take:
I think the last sentence says it all, Americans (think American healthcare) don’t have the scientific evidence they need to support CAM therapies. All NIH really needs to do is look beyond our borders as there is a significant body of evidence to support CAM therapies. Australia, India, China and Europe have conducted tens of thousands of studies on a wide range of CAM therapies.

For example, the Australian study on chiropractic care published in 1976 still ranks as a much more definitive study than anything NIH has supported here in the U.S. PubMed, a service of NIH lists over 500 studies on Boswellia and more than 1,000 on Echinacea. These are all from peer-reviewed journals posted on the NIH website, but totally ignored by NCCAM.

The Bottom Line:
NCCAM is fifty years behind the rest of the world. Their “research” does little beyond adding conventional support to therapies that have been well established for generations. They are “poised” to remain irrelevant until they review the current literature and support meaningful studies.

Source: National Institutes of Health