Alternative Medicine

limitations of alternative therapies (book)

- lack of info on effectiveness - natural products carry risks of adverse reactions also classified by food by gov't so products are not evaluated by effectiveness but by safety - massage not effective for some people - chiropractic treatment may be harmful to - accupunture & accupressure doesnt work for anyone - sometimes by themselves, they're not as effective - accessibility is a limitation - one way to increase this is to increase the prescence of alternative medicine in conventional medical settings

Overall research on acupuncture

100 randomized constrolled trails; mixed results provides some patients with some relief from: osteoarthritis back pain migraines menstrual pain tennis elbow postoperative dental pain

Ideals of CAM

Natural, holistic, and promotes wellness "back to nature" backlash Combat overspecialization and fragmentation (dr's are specialized & not in touch with reality of other treatments) focus on optimal state of vitality (not just about treatment but about improving overall quality of life)

Energy healing- mind body medicinE

Reiki massage but directing energy from the universe through the hands of a practiioner and to the body of the recipient can help with pain

Trends toward CAM

Trends that led to HP also increased interest in CAM - costly, impersonal nature of biomedicine - adverse effects of treatment - profit-driven nature of healthcare - more activist, consumer-oriented view of the patient role

Complementary and alternative medicine (CAM)

Use and practice of therapies or diagnostic techniques that fall outside conventional medicine

Domains of CAM

Whole medical systems - systems designed outside of Western medicine (chinese meds, ayurveda) Mind and body medicine - target minds influence on bodily function/symptoms (meditation, acupuncture) Natural products - herbal medicines, vitamins, minerals Manipulative & body-based practices - target structure and systems of body (bones, joints, soft tissue, circulatory systems, etc. ex- spinal cord manipulation, massage therapy) Other CAM practices - movement therapies, traditional healers, manipulation of various energy fields, putative energy field

Integrative medicine

a way to overcome the limitations of both conventional medicine & CAM by integrating them and providing a mixture of both types of treatment requires conventional and alternative medicine practioners to accept the effectiveness of both approaches & to work together

conventional

biomedically based MD's or DOs (doctor of osteopathy) and allied health professionals

Alternative pracites

chiropractic treatment massage diets, supplements, natural products

Holistic medicine

considers emotional, spiritual, social, psychological well being in addition to physical health

Qi gong - mind body medicine

cultivation of the qi by postures & simple movement that channel vital energy & restore balance in the body seeks to prevent disease, promote long life, and treat specific diseases such as hypertension, diabetesm heart disease, and stress & pain

Alternative explanations for improvement

decreased anxiety (the fact that ppl are getting treatment eases them) classical conditioning (+ effects associated with treatment you can expect to feel better) placebos may tap natural "inner pharmacy"of self healing substances any medical procedure can have placebo effect (imp't in cam because we don't hace CT)

Researching CAM

differences in perspective & FOCUS - controlled clinical trials (no way to do CT, no evidence based treatment) CAM evidence often based on informal case studies - self-report and single outcome measures

effectiveness of chiropractic treatments

enormous popularity especially for back pain - licensed in al 50 states - covered by most insurances Critics argue that misaligned vertebra are common, and harmless. Will heal on their own Retrospectice and prospective evidence supports: efficacy of chiropractic in treating lower back pain

ethnic use in CAM

european americans are more likely than AA or hispanics to use cam recent immigrants less likely to use cam than immigrants who have been in US for years asians use it the most (related to their culture)

mindfulness meditation- mind body medicine

focus on any thoughts or sensations as they occur trying to enhance their own awareness of their perceptions and thought processes in a nonjudgemental way in the moment PREFRONTAL AND ANTERIOR CINGULATE CORTEX have higher levels of activation which can help in anxiety nd stress

Alternative medicine

group of diverse medical and health care systems, practices, and products that are not currently considered part of conventional medicine

relaxation training shown to

increase natural killer cell activity and boost serotonin levels

Ayurvedic medicine

integrate and balance the body, mind & spirit events disrupting our balance goals of treatment are to eliminate impurities & and increase harmony

Massage

manipulates soft tissue to produce health benefits alternative therapy used to control stress & pain

Pain techniques in cam

meditation and guided imagery GI- pregnancy and childbirth tai chi- tension headaches acupuncture massage chiropractic biofeedback hypnotic pain

Acupuncture

most successful in treating pain - practitioners believe it rejuvenates the body most heavily researched CAM technique numerous studies but not controlled lack of standardization sham acupunture may help with depression

Yoga -mind body medicine

physical postures breathing and meditation balance body, mind, and spirit live in bodies in the moment stress management, depression

Guided imagery- mind body medicine

ppl conjure a calm peaceful image and concentrate on that image for the duration of the situation assumption is that a person cannot concentrate on more than one thing at a time therefore imagining a scene will divert attention from their painful experice

transcendental meditation- mind body medicine

ppl sit with eyes closed & muscles relaxed focus attention on their breathing and silently repeat a sound with each breath for about 20 minutes focused consciousness focus on a single thought or image may alter response to pain and bolster immune system stress management

Evidence- based medicine

promotes use of research-based evidence in making medical decisions

Tai chi - mind body medicine

slow, gentle movements that shift the weight while the person maintains an upright yet relaxed posture and controlled breathing

hypnotic treatment

somewhat controversial some practioners use hypnotherapy to help with pain divided or disassociated consciousness? SOME ARGUE ITS JUST RELAXATION AND WE DO NOT NEED TO PUT SOMEONE IN A TRANCE LIKE STATE

Chirpopractic treatments

targets disorders of the neuromusculoskeletal system manipulating of the spineE traditional approach - misalignments cause pain - treat range of problems (asthma, low back pain) mixed approach - conbine traditional manipulations with other CAM therapies - limited range of conditions

motivations towards cam

techniques compatible with their worldviews when others meds haven't relieved their pain ppl in poor health

mind body medicine

the brain, mind, body, and behavior interact in complex ways and that emotional, mental, social, and behavioral factors exert important effects on health

Biofeedback - mind body medicine

the process of providing feedback info about the status of biological systems allows person to alter physiological responses that connot be voluntarily controlled without the biofeedback inforamtion

Possible causes of improvement

treatment is effective misdiagnosis illness improved on its own - spontaneous remission - cyclical conditions (arthritis) Placebo effect - placebo & nocebo

age and gender use in cam

usually female and well educated upper income

complementary medicine

when alternative & conventional medicine are used together when a person uses both massage and analgesic drugs to control pain