Almost all of us have some experience with alternative medicine. Whether it be unwinding at the spa, stretching out on a yoga mat, or trying acupuncture out of curiosity, non-conventional therapies are becoming more and more popular within the Western world. And while there are many definitions of alternative medicine, in general, it describes pseudoscientific treatments used to replicate the healing effects of traditional medical practices, while not having any proven benefits beyond placebo. When these practices are used simply for relaxation, they can be harmless, even beneficial for one’s mental state. It is when alternative medicine is used in the place of scientific therapies that they can become dangerous. However, many swear by these unconventional therapies, truly believing they work to resist illness. Is it possible that there are grains of truth to some of these unorthodox remedies? This article dives deeper into a few alternative medicines to explore whether they are nonsensical quackery, or verifiable reality.
Firstly, acupuncture is one of the most well-known forms of alternative medicine. The practice originated at least 2,000 years ago in China, with some evidence giving its origin at around 5,000 years ago (Ernst, 2005). In Traditional Chinese Medicine (TCM), the energy or qi of the body is thought to circulate through cyclical pathways called meridians; proper qi circulation is integral for overall health. As a branch of TCM, acupuncture attempts to correct imbalances or blockages in the flow of qi by tapping into hundreds of acupuncture points lying on the meridians (Liu et al., 2015). This is usually done with sharp, hair-thin needles, but acupuncture points may also be stimulated with heat, pressure, or lasers.
Although no researchers have yet found evidence for the existence of qi, some studies have attempted to explain the mechanisms of acupuncture in more modern terms. Most of these explanations involve the needles triggering the central nervous system, causing the release of hormones into the brain, muscles, and nerves to stimulate natural healing. For example, one study used functional magnetic resonance imaging (fMRI) technologies to measure subjects’ brain activity while they underwent acupuncture. The researchers found that the needles caused regions of the participants’ limbic system, the part of the brain that deals with emotions, to be activated or repressed (Napadow et al., 2005). Exactly how this leads to physiological changes is not made clear by the study. Other studies have suggested that acupuncture decreases pain by stimulating A delta fibers (nerves conveying pain signals in the skin and muscles), through activation of certain gray-matter cells of the spinal cord, or by influencing the hypothalamus in the brain, which triggers the release of hormones by the pituitary gland (Ernst, 2005).
However, many researchers have called into question whether acupuncture even has a healing mechanism, with thousands of studies being conducted to test its efficacy. The results have been decidedly inconclusive, with many studies concluding acupuncture is effective at treating pain and curing minor disorders, e.g. (Liu et al., 2015); (Melchart et al., 2005), (Vas et al., 2004) and many other studies concluding just the opposite, e.g. (Chien et al., 2019); (Ernst et al., 2010); (Ahn et al., 2008). Why is the scientific community so divided on whether acupuncture really works? For one, it is surprisingly difficult to create a proper control group for acupuncture research. After all, how do you poke someone with needles in a way that they believe is true acupuncture, but in actuality is fake? “Sham” acupuncture cannot simply utilize needle points that are not real acupuncture points, since almost every region of the body is associated with a meridian; and it cannot involve non-penetrating needles, since this could lead to a different needle experience for the participant, and thus flawed results (Linde et al., 2001). Overall, the current research does not have definitive evidence either against or in favor of the reality of acupuncture. The good news is that it does not have any serious adverse effects when done by a trained professional (Ernst, 2005).
Another common form of alternative medicine is chiropractic therapy. Interestingly, many people don’t recognize it as an unproven technique, but as a science, and about $3 billion per year is spent on chiropractic care (Ernst, 2008). Invented in 1895 by Dr. Daniel Palmer, the therapy’s origins lie much closer to modern times than acupuncture. Chiropractic techniques rest on the belief that many disorders and pains are caused by misalignments of the spinal vertebrae, also called vertebral subluxations. Trained chiropractitioners can shift the position and angle of individual vertebrae in the spine, as well as other joints in the body, supposedly correcting the misalignments and healing the patient (Kaptchuk & Eisenberg, 1998). The exact physiological mechanism by which this realignment alleviates pain is not known, or even speculated on to a considerable degree.
Like acupuncture, the effectiveness of chiropractic is controversial. One study found that chiropractic treatments resulted in “moderate short-term improvements in lower back pain intensity and disability” among subjects (Goertz et al., 2018). However, many more systematic reviews have been conducted by researchers, compiling and synthesizing the results of dozens of chiropractic studies, in total comprising data from thousands of participants. These studies have conclusively found that chiropractic therapies do not effectively treat most pains and disorders as they are advertised, compared to placebo (Rubinstein et al., 2013); (Pozadski, 2012); (Ernst & Canter, 2006). However, they also conclude the treatment does have value in lessening lower back pain, although to a lesser degree than expected. Furthermore, these benefits might simply be chalked up to chiropractitioners massaging patients as they shift the vertebrae of the spine (Ernst & Canter, 2006). Despite this, chiropractic treatments continue to have more mainstream support than other alternative medicines, even being covered by Medicare in some states (Medicare.gov, 2020).
The last alternative medicine that will be extensively examined in this article is homeopathy. This treatment (if it can even be called that) relies on the counterintuitive principle that “like cures like.” For example, homeopaths might use bee venom ointment as a salve for bee stings, believing the venom to heal the injury that it created in the first place (Cukaci et al., 2020). However, this venom would be tremendously diluted: many homeopathic remedies are diluted to a factor of 1 part active ingredient to 1060 parts water or alcohol. With this enormous scale factor, the resulting serum is so diluted that literally zero molecules of the active ingredient remain in the solution (Cukaci et al., 2020). Nevertheless, homeopaths maintain that water can “remember” the materials it comes into contact with, and that the dilution in fact increases the potency of the chemicals; thus, homeopathic medicine can heal without any substantial medicinal components (Grams, 2019). Some have even suggested this occurs through quantum entanglement of the water molecules with the materials.
Homeopathy may seem fruitless at first glance, and research confirms this conclusion. Creating a proper control group for homeopathy to account for the placebo effect is relatively straightforward, so the results from research trials are more concrete than other alternative medicines. One holistic systematic review of previous systematic reviews of homeopathy synthesizes nearly all of the rigorous testing that has been completed prior to 2010. It concluded that these studies altogether showed no evidence to support homeopathy as a treatment beyond placebo (Ernst, 2010). Despite this, homeopathy remains relatively popular in society. One study found that about 2% of Americans have used homeopathic remedies within the last 12 months (Relton et al., 2017). Although this may not seem like a large statistic, it means that more than 6.5 million Americans bought homeopathic medicine in the last year alone.
Many alternative medicines exist other than the three covered so far. Unfortunately, there are too many to be thoroughly reported on in this article. Therefore, the following will be an alternative medicine “lightning round” explaining the basic principles and efficacy of some prominent treatments:
In a Japanese therapy called Reiki, practitioners claim they are able to transfer their energy to the sick by placing their palms on their subjects’ chakras, manipulating their qi. (Thrane et al., 2014)
Bioresonance therapy proposes that electromagnetic waves can diagnose and treat illnesses. However, its mechanism and efficacy is unproven. (Pihtili et al., 2014)
Crystal healing utilizes semiprecious gemstones, such as quartz, amethyst, and opals, to heal a variety of illnesses and diseases via the body’s chakra points. (McClean, 2005)
Detoxification, often shortened to “detox,” aims to remove a wide variety of “toxins” from the body that are said to create physiological imbalances, typically through extreme fasting or juice cleanses. However, this diet is remarkably unsustainable and dangerous, and detox therapies have been proven ineffective. (Klein & Kiat, 2014)
Although yoga is often thought of as just a series of simple exercises, it is also a healing system that has been practiced in South Asia for millenia. It involves a group of physical postures, breathing techniques, and meditation that harnesses the body’s energy for natural healing. Yoga does lend proper coordination, posture, digestion, and more to its practitioners; however, this is most likely due to its exercise characteristics rather than some spiritual connection. (Bridges & Sharma, 2017)
Tai chi is a Chinese martial art that has a dual purpose in self-defense and self-healing. Its slow speeds and soft movements provide an alternative to faster exercises for some. However, research has indicated that it does not lend all of its advertised benefits to its followers, such as protection from Parkinson’s Disease, heart disease, or cancer. Tai chi is also similar to qigong, another system of coordinated posture and movement. (Pihtili et al., 2014)
Bibliotherapy involves the storytelling or reading of specific books with strong connections to the reader, leading to changes in behavior and reductions in stress. Bibliotherapy has proven effective for treating substance abuse, depression, and other mental health disorders. (Fanner & Urquhart, 2008)
In general, alternative medicines do not bestow the intended effects onto its practitioners. Most alternative medicines do not show medicinal benefits at all, and the few exceptions do so to a limited degree. While acupuncture, chiropractic, and yoga might do wonders for relaxation and meditation, they are not substitutes for scientific therapies and real doctors. This is why the general trend of more and more people using alternative medicine is troubling. According to a survey by the CDC, 36% of Americans, or 120 million people, have recently used alternative medicine (Wong, 2019). And the market for homeopathy alone is expected to reach $17 billion in a few years (Ernst, 2010). Why do so many people turn to these pseudoscientific methods in lieu of contemporary medicine? In part, it is because alternative treatments like homeopathy and acupuncture provide a person-to-person connection that is often lacking in the modern health care system. Practitioners of homeopathic medicine may take hours to sit down with their patients to discuss their illness, treatments, and personal lives. This is in contrast to certified physicians, who are often too busy to spend this time and energy on those individuals they help. Although alternative medicine seems to lie solidly within the bounds of pseudoscience, modern medicine could learn from the emotional treatment that it provides its subjects, in order to prevent more people from jeopardizing their health with ineffective therapies.
References
Ahn, A. C., Colbert, A. P., Anderson, B. J., Martinsen, Ø. G., Hammerschlag, R., Cina, S., Wayne, P. M., & Langevin, H. M. (2008). BMC complementary and alternative medicine, https://doi.org/10.1002/bem.20403
Bridges, L., & Sharma, M. (2017). The Efficacy of Yoga as a Form of Treatment for Depression. Journal of evidence-based complementary & alternative medicine, 22(4), 1017–1028. https://doi.org/10.1177/2156587217715927
Chien, T. J., Liu, C. Y., & Fang, C. J. (2019). The Effect of Acupuncture in Breast Cancer-Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis. Integrative cancer therapies, 18, 1534735419866910. https://doi.org/10.1177/1534735419866910
Cukaci, C., Freissmuth, M., Mann, C., Marti, J., & Sperl, V. (2020). Against all odds-the persistent popularity of homeopathy. Wiener klinische Wochenschrift, 132(9-10), 232–242. https://doi.org/10.1007/s00508-020-01624-x
Ernst, E., Lee, M. S., & Choi, T. (2010). Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews. International Association for the Study of Pain, http://www.dcscience.net/Ernst-2011-AcupunctAlleviatePainRiskReview.pdf
Ernst, E., & Canter, P. H. (2006). A systematic review of systematic reviews of spinal manipulation. Journal of the Royal Society of Medicine, 99(4), 192–196. https://doi.org/10.1258/jrsm.99.4.192
Ernst, E. (2005). Acupuncture — a critical analysis. Journal of Internal Medicine, https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2796.2005.01584.x
Ernst, E. (2008). Chiropractic: A Critical Evaluation. Journal of Pain and Symptom Management, https://doi.org/10.1016/j.jpainsymman.2007.07.004
Ernst, E. (2010). Homeopathy: what does the “best” evidence tell us? The Medical Journal of Australia, 192(8), https://doi.org/10.5694/j.1326-5377.2010.tb03585
Fanner, D. & Urquhart, C. (2008). Bibliotherapy for mental health service users Part 1: a systematic review. Health Information and Libraries Journal, 25(4), 237–252. https://doi.org/10.1111/j.1471-1842.2008.00821.x
Goertz, C. M., Long, C. R., Vining, R. D., Pohlman, K. A., Walter, J., & Coulter, I. (2018). Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial. JAMA network open, 1(1), e180105. https://doi.org/10.1001/jamanetworkopen.2018.0105.x
Grams N. (2019). Homeopathy-where is the science? A current inventory on a pre-scientific artifact. EMBO reports, 20(3), e47761. https://doi.org/10.15252/embr.201947761
Kaptchuk, T. J., & Eisenberg, D. M. (1998). Chiropractic Origins, Controversies, and Contributions. JAMA Internal Medicine, 158(20), https://doi.org/10.1001/archinte.158.20.2215
Klein, V. & Kiat, H. (2014). Detox diets for toxin elimination and weight management: a critical review of the evidence. The Official Journal of the British Dietetic Association, 28(6), https://doi.org/10.1111/jhn.12286
Linde, K., Vickers, A., Hondras, M., ter Riet, G., Thormählen, J., Berman, B., & Melchart, D. (2001). Systematic reviews of complementary therapies - an annotated bibliography. Part 1: acupuncture. BMC complementary and alternative medicine, 1, 3. https://doi.org/10.1186/1472-6882-1-3
Liu, L., Skinner, M., McDonough, S., Mabire, L., & Baxter, G. D. (2015). Acupuncture for low back pain: an overview of systematic reviews. Evidence-based complementary and alternative medicine : eCAM, 2015, 328196. https://doi.org/10.1155/2015/328196
McClean, S. (2005). ‘The illness is part of the person’: discourses of blame, individual responsibility and individuation at a centre for spiritual healing in the North of England. Sociology of Health and Illness, 27(5), 628–648. https://doi.org/10.1111/j.1467-9566.2005.00459.x
Medicare.gov. (2020). Coverage for Chiropractic Services. Medicare, https://www.medicare.gov/coverage/chiropractic-services
Melchart, D., Streng, A., Hoppe, A., Brinkhaus, B., Witt, C., Wagenpfeil, S., Pfaffenrath, V., Hammes, M., Hummelsberger, J., Irnich, D., Weidenhammer, W., Willich, S. N., & Linde, K. (2005). Acupuncture in patients with tension-type headache: randomised controlled trial. BMJ (Clinical research ed.), 331(7513), 376–382. https://doi.org/10.1136/bmj.38512.405440.8F
Napadow, V., Makris, N., Liu, J., Kettner, N. W., Kwong, K. K., & Hui, K. K. (2005). Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Human brain mapping, 24(3), 193–205. https://doi.org/10.1002/hbm.20081
Pihtili, A., Galle, M., Cuhadarkoglu, C., Kiliclasan, Z., Issever, H., Erkan, F., Cagatay, T., & Gulbaran, Z. (2014). Evidence for the Efficacy of a Bioresonance Method in Smoking Cessation: A Pilot Study. Complementary Medicine Research, https://doi.org/10.1159/000365742
Pozadski, P. (2012). Is Spinal Manipulation Effective for Pain? An Overview of Systematic Reviews. Pain Medicine, 13(6), https://doi.org/10.1111/j.1526-4637.2012.01397.x
Relton, C., Cooper, K., Viksveen, P., Fibert P., & Thomas, K. (2017). Prevalence of homeopathy use by the general population worldwide: a systematic review. School of Health and Related Research, http://dx.doi.org/http://dx.doi.org/10.1016/j.homp.2017.03.002
Rubinstein, S. M., Terwee, C. B., Assendelft, W. J. J., de Boer, M. R., & van Tulder, M. W. (2013). Spinal Manipulative Therapy for Acute Low Back Pain: An Update of the Cochrane Review. Spine, 38(3), https://doi.org/10.1097/BRS.0b013e31827dd89d
Thrane, S., & Cohen, S. M. (2014). Effect of Reiki therapy on pain and anxiety in adults: an in-depth literature review of randomized trials with effect size calculations. Pain management nursing : official journal of the American Society of Pain Management Nurses, 15(4), 897–908. https://doi.org/10.1016/j.pmn.2013.07.008
Vas, J., Méndez, C., Perea-Milla, E., Vega, E., Panadero, M. D., León, J. M., Borge, M. A., Gaspar, O., Sánchez-Rodríguez, F., Aguilar, I., & Jurado, R. (2004). Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial. BMJ (Clinical research ed.), 329(7476), 1216. https://doi.org/10.1136/bmj.38238.601447.3A\
Wong, C. (2019). Complementary and Alternative Medicine Use in the U.S. Verywellhealth, https://www.verywellhealth.com/alternative-medicine-usage-in-the-us-88732
Written by Alex Borengasser
Edited by Devanandh Murugesan
Graphics by Tiya Shah
Group advised by Lakshmi Sriram
Comentarios