Complementary and alternative medicine (CAM)

Complementary and alternative medicine, as defined by the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH), is a group of diverse medical and health care systems, practices and products that are not presently considered to be part of conventional medicine.  While some scientific evidence exists regarding some CAM therapies, for most there are questions regarding safety, efficacy, and disease-specific actions that remain to be answered through well-designed scientific studies.

Overview of therapies

In order to make sense out of the many different forms of complementary therapies, experts at NCCAM established a structure based upon the presumed way the various therapies are thought to work. Although exact mechanisms of actions for most of these therapies are not fully understood, this organization makes it possible to group similar therapies together.

Alternative medical systems

Alternative medical systems are built upon systems or philosophies of theory and practice which have often evolved apart from and earlier than the conventional medical approaches used in the United States. Common examples include:

  • Homeopathy
  • Naturopathy
  • Traditional Chinese medicine
  • Ayurveda

Mind-body interventions

Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to affect the bodily function and symptoms.

  • Meditation
  • Mental healing
  • Music therapy
  • Art therapy
  • Dance therapy
  • Yoga
  • Biofeedback

Biologically based therapies

Biologically based therapies use substances found in nature, such as herbs, foods, and vitamins. (These products might have interactions with other drugs being taken. It is important to share with a health professional all supplements and drugs being taken.)

  • Dietary supplements
  • Herbal products
  • Vitamins
  • Prescription drugs

Manipulative and body-based methods

Manipulative and body-based methods are based on movement or one or more parts of the body.

  • Traditional surgery
  • Osteopathic and chiropractic manipulation
  • Alexander technique
  • Feldenkrais method
  • Massage therapy
  • Reflexology
  • Rolfing
  • Exercise

Energy therapies

Energy therapies involve the manipulation and enhancement of the body's energy fields.

  • Acupuncture
  • Bioelectromagnetic therapy
  • Energy Healing
  • Qi Gong
  • Prayer and ritual
  • Laying-on-of-hands
  • Homeopathy
  • Traditional Chinese medicine
  • Religious and spiritual healing

Frequency of use of complementary therapies

According to a new nationwide government survey, 36 percent of U.S. adults aged 18 years and over use some form of complementary and alternative medicine. CAM is defined as a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. When prayer specifically for health reasons is included in the definition of CAM, the number of U.S. adults using some form of CAM in the past year rises to 62 percent.

The survey, administered to more than 31,000 representative U.S. adults, was conducted as part of the Centers for Disease Control and Prevention's 2002 National Health Interview Survey. Developed by NCCAM and the CDC's National Center for Health Statistics, the survey included questions on 27 types of CAM therapies commonly used in the United States. These included ten types of provider-based therapies, such as acupuncture and chiropractic, and 17 other therapies that do not require a provider, such as natural products (herbs or botanical products), special diets, and megavitamin therapy.

Although there have been many surveys of CAM use to date, the various surveys included fewer choices of CAM therapies. In addition, they often surveyed smaller population samples primarily relying on telephone or mail surveys versus in-person interviews used for this survey. Thus, the results from the CAM portion of the NHIS provide the most comprehensive and reliable data to date describing CAM use by the U.S. adult population.

Overall, the survey revealed that CAM use was greater among a variety of population groups, including women; people with higher education; those who had been hospitalized within the past year; and former smokers, compared to current smokers or those who had never smoked. In addition, this was the first survey to yield substantial information on CAM use by minorities. For example, it found that African American adults were more likely than white or Asian adults to use CAM when megavitamin therapy and prayer were included in the definition of CAM.

"We're continuously expanding the health information we collect in this country, including information on the actions people take in dealing with their own health situations," said NCHS Director Edward J. Sondik, PhD. "Over the years we've concentrated on traditional medical treatment, but this new collection of CAM data taps into another dimension entirely. What we see is that a sizable percentage of the public puts their personal health into their own hands."

CAM approaches were most often used to treat back pain or problems, colds, neck pain or problems, joint pain or stiffness, and anxiety or depression. However, only about 12 percent of adults sought care from a licensed CAM practitioner, suggesting that most people who use CAM do so without consulting a practitioner. According to the survey, the 10 most commonly used CAM therapies and the approximate percent of U.S. adults using each therapy were:

  • Prayer for own health, 43 percent
  • Prayer by others for the respondent's health, 24 percent
  • Natural products (such as herbs, other botanicals, and enzymes), 19 percent
  • Deep breathing exercises, 12 percent
  • Participation in prayer group for own health, 10 percent
  • Meditation, 8 percent
  • Chiropractic care, 8 percent
  • Yoga, 5 percent
  • Massage, 5 percent
  • Diet-based therapies (such as Atkins, Pritikin, Ornish, and Zone diets), 4 percent.

In addition to gathering data on the use of CAM practices, the survey also sought information about why people use CAM. Key findings indicate that:

  • 55 percent of adults said they were most likely to use CAM because they believed that it would help them when combined with conventional medical treatments;
  • 50 percent thought CAM would be interesting to try;
  • 26 percent used CAM because a conventional medical professional suggested they try it; and
  • 13 percent used CAM because they felt that conventional medicine was too expensive.

Interestingly, the survey also found that about 28 percent of adults used CAM because they believed conventional medical treatments would not help them with their health problem. This is in contrast to previous findings that CAM users are not, in general, dissatisfied with conventional medicine.

The results of the survey reveal new patterns of CAM use among various population groups and provide a rich source of data for future research. Furthermore, the survey results provide a baseline for future surveys, as it establishes a consistent definition of CAM that can be used to track trends and prevalence of CAM use. (Barnes P, Powell-Griner E, McFann K, Nahin R. CDC Advance Data Report #343. Complementary and Alternative Medicine Use Among Adults: United States, 2002. May 27, 2004.)

More discussion of the terms

  • Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient's discomfort following surgery.
  • Alternative medicine is used in place of conventional medicine. For example, the use of a special diet for treating cancer instead of undergoing chemotherapy that has been recommended by a conventional doctor. At Children's Memorial, we provide proven, standard medical care for all of our patients and do not recommend "alternative" treatment.
  • Integrative medicine as defined by NCCAM combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.
  • Collaborative medicine is a term which describes a team approach. Each member of the collaborative team; physician, healthcare worker, practitioner and therapist brings to the team their own area of expertise and training. The whole team understands when to refer to each other and when to collaborate. It also includes the concept that the patient and family is a partner in their own health care.