Complementary and Alternative Medicine Dr Monem Alshok 2018
Complementary and Alternative Medicine CAM Definitions CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine.
Complementary and Alternative Medicine Complementary medicine is used together with conventional medicine. Alternative medicine: is used in place of conventional medicine. (e.g.) using special diet to treat cancer instead of chemotherapy, surgery, etc...or certain Herbs to treat DM Integrative medicine : combines treatments from conventional medicine and CAM for which there is evidence of safety and effectiveness.
Alternative Medical Systems: Complete systems of medical theory and practice. e.g. Homeopathic Medicine, In homeopathic medicine, there is a belief that "like cures like," meaning that small, highly diluted quantities of medicinal substances are given to cure symptoms, when the same substances given at higher or more concentrated doses would actually cause those symptoms.
Introduction to CAM More than 30% of adults use complementary and alternative therapies Relieve problems Promote wellness No relief from traditional treatments 44-5
Roots of Nontraditional Therapies Ancient Greece: massage, art therapy, herbal therapy. The Far East: energetic-touch therapies. China: acupuncture, herbalism. India: Ayurvedic medicine.
History of CAM : 25% of all pharmaceutical drugs are derived from herbs. Prior to 1990 little was known about who was using CAM 1993 study showed that 1 in 3 Americans sought some form of alternative care 1997 another follow up study revealed that 47% of Americans were using some form of CAM
History Ayurveda 1500 BC to AD 500 Acupuncture 5,000 years old Traditional Chinese Medicine (TCM) 2,000 years old Homeopathy 1790s
Types of CAM( 4 Main Domains of CAM 1. Mind-Body Medicine : techniques designed to enhance the mind's capacity to affect bodily function and symptoms ( e.g. ) meditation, mental healing 2. Energy Medicine : therapies affecting body energy fields (qi gong, healing touch, Reiki) or unconventional use of electro-magnetic fields using 3. Manipulative and Body-based Practices : chiropractic or osteopathic manipulation or massage therapy 4. Biologically based products & Naturopathy : herbs and other dietary supplements (Most commonly used type of CAM are dietary supplements/herbs )
Manipulative and Body-Based Methods:Based on the manipulation and/or movement of one or more parts of the body. Types: Massage therapy Chiropractic manipulation Reflexology Osteopathy Massage: include Pressure, kneading, stroking, vibration, and tapping to positively affect health
What are the Effects of Massage Techniques : 1. Relaxation 2. Counteracts effects of stress 3. Lowers heart rate and blood pressure 4. Reduces pain / relaxes muscle spasms 5. Improves concentration 6. Promotes restful sleep 7. Helps the mind relax
Chiropractic medicine Adjustments by Manual treatments to re-align the vertebra and restore function of spinal nerves. Chiropractor : Performs an exam and takes a history Tests: X-rays,Muscle testing,analyzes posture
Naturopathic Medicine: Proposes that there is a healing power in the body that establishes, maintains, and restores health. Practitioners work with the patient with a goal of supporting this power, through treatments such as nutrition and lifestyle counseling, dietary supplements, medicinal plants, and exercise
There are six principles that form the basis of naturopathic practice: The healing power of nature Identification and treatment of the cause of disease The concept of "first do no harm" The doctor as teacher Treatment of the whole person Prevention
Naturopathy: include 1. Diet modification and nutritional supplements, 2. Herbal medicine, 3.Acupuncture and Traditional Chinese medicine, 4. Hydrotherapy, 5. Massage and joint manipulation The application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health.
In general we can said : The Main complaints for which patients use CAM include : Headache, Pains,Anxiety, Back pain,joint pain, Cancer, Gastrointestinal disorders or sleeping problems
Who Uses CAM? In 2004 survey results: More women than men. Higher education levels, Hospitalized in the past year. Former smokers
Homeopathy: In the late 1700s, Samuel Hahnemann, a physician, chemist, and linguist in Germany, proposed a new approach to treating illness. Treatments of the time were harsh, and wanted a less threatening way to practice medicine. Like cures like Potentiating and holism. The World Health Organization noted in 1994 that homeopathy had been integrated into the national health care systems of numerous countries, including Germany, the United Kingdom, India, Pakistan, Sri Lanka, and Mexico. In European countries, training in homeopathy is usually pursued either as a primary professional degree completed over 3 to 6 years or as postgraduate training for doctors.
In the United States, training in homeopathy is offered through diploma programs, certificate programs, short courses, and correspondence courses. Also, homeopathic training is part of medical education in naturopathy. Most homeopathy in the United States is practiced along with another health care practice for which the practitioner is licensed, such as conventional medicine, naturopathy, chiropractic, dentistry, acupuncture, or veterinary medicine (homeopathy is used to treat animals).
What we mean by Manipulative and Body-Based Methods? * Chiropractic medicine involves manipulative techniques to correct abnormalities of spine &the musculoskeletal system. Chiropractic Medicine -focuses on the relationship between bodily structure (primarily that of the spine) and function, and how that relationship affects the preservation and restoration of health. Chiropractors use manipulative therapy as an integral treatment tool
* Osteopathic medicine: a medical field incorporating manipulative techniques for correcting abnormalities of musculoskeletal system. Osteopathic Medicine -emphasizes diseases arising in the musculoskeletal system. There is an underlying belief that all of the body's systems work together, and disturbances in one system may affect function elsewhere in the body. Osteopathic physicians practice osteopathic manipulation, a full-body system of hands-on techniques to alleviate pain, restore function, and promote health and wellbeing * Massage Therapy -manipulate muscle and connective tissue to enhance function of those tissues and promote relaxation and wellbeing
Energy Therapies : Biofield Theories-affect energy fields that purportedly surround and penetrate the human body Therapeutic Touch Healing Touch Reiki Quantum Healing Qi-Gong : Bioelectromagnetic Theories-unconventional use of electromagnetic fields. Magnetic Healing Radionics
What is Mind Body Medicine? Mind/Body Therapy : Reviewed by Astin, et al. Concluded that there is considerable evidence that Mind Body are beneficial:for: Coronary artery disease Headaches Insomnia Chronic low back pain Treatment related symptoms of cancer
The principle of this therapy is that : Imagery is the biological connection between the mind and body. As we will see, this is extremely useful in mind body healing. Techniques designed to enhance the mind's capacity to affect bodily function and symptoms include : Meditation Prayer Mental Healing, Art, Music and Dance Therapy
Mind Body Medicine is a type of CAM based on the Belief that emotional, mental,social, spiritual, and behavioral factors affect health. Respects and encourages individual s capacity for self knowledge and self-care. Techniques include Yoga or tai chi Relaxation therapies Cognitive & behavioral therapies Group support Meditation Creative arts therapy
Meditation Quieting the mind by focusing the attention. Benefits include: stress relief, relaxation, reduced level of lactic acid, efficient & effective oxygen consumption, slowed heart rate, decreased blood pressure, improved functioning of the immune system.
Bio-feedback The measurement of physiological responses that yields information about the relationship between the body and mind and helps clients learn ways to manipulate those responses through mental activity.
Uses of Bio-feedback A restorative method in rehabilitation settings for clients who have lost sensation and function as result of injury or illness. To relieve tension headaches, migraines and backache. To reduce bruxism (grinding of the teeth). To lower blood pressure. Temperature bio-feedback useful in treating Raynaud s disease (constriction and spasms of small arteries).
Therapeutic Hypnosis Induces an altered state of consciousness or awareness resembling sleep during which the person is more receptive to suggestion. Hypnosis also enhances client s ability to form images (for guided imagery).
What is Ayurveda? A comprehensive system of medicine developed in India that places equal emphasis on the body, mind, and spirit, and strives to restore innate harmony of the individual. Primary treatments include diet, exercise, meditation, herbs, massage, and controlled breathing. Ayurveda, which literally means: "the science of life," is a natural healing system developed in India. Ayurvedic texts claim that the sages who developed India's original systems of meditation
Ayurveda is a conscious mental process using certain techniques such as : * Focusing attention or maintaining a specific posture -- to suspend the stream of thoughts and relax the body and mind. and yoga developed the foundations of this medical system. * It is a comprehensive system of medicine that places equal emphasis on the body, mind, and spirit, and strives to restore the innate harmony of the individual. * Some of the primary Ayurvedic treatments include diet, exercise, meditation, herbs, massage, exposure to sunlight, and controlled breathing.
In India, Ayurvedic treatments have been developed for various diseases (e.g., diabetes, cardiovascular conditions, and neurological disorders). However, a survey of the Indian medical literature indicates that the quality of the published clinical trials generally falls short of contemporary methodological standards with regard to criteria for randomization, sample size, and adequate controls.
Traditional Chinese Medicine it is a type of CAM based on the following : Health is achieved by maintaining the body in a "balanced state. Imbalance leads to blockage in the flow of qi.energy which flow in the body in certain Meridians CAM practioners typically use herbs, acupuncture, and massage to help unblock qi in an attempt to bring the body back into harmony and wellness
Traditional Chinese Medicine TCM : TCM based on a concept of balanced qi, or vital energy, that is believed to flow throughout the body. Qi is proposed to regulate a person's spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of yin (negative energy) and yang (positive energy). Disease is proposed to result from the flow of qi being disrupted and yin and yang becoming imbalanced
Acupuncture: is one type of traditional chinnes Medicine through which they use of insertion of Hair Thin needles into a non anatomic energy channels called Meridians.
There are three main therapeutic modalities: 1. Acupuncture and moxibustion In traditional Chinese medicine, the use of heat from burning the herb moxa on or near the skin at an acupuncture point. Intended to stimulate the flow of qi and restore health. (moxibustion is the application of heat from the burning of the herb A plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. moxa at the acupuncture point) 2. Chinese Materia Medica is a standard reference book of information on medicinal substances that are used in Chinese herbal medicine. 3. Massage and manipulation
TCM is a complete system of healing that dates back to 200 B.C. in written form. Korea, Japan, and Vietnam have all developed their own unique versions of traditional medicine based on practices originating in China.
In the TCM view: The body is a delicate balance of two opposing and inseparable forces: yin and yang. The concept of two opposing yet complementary forces described in traditional Chinese medicine. Yin represents cold, slow, or passive aspects of the person, while yang represents hot, excited, or active aspects. A major theory is that health is achieved through balancing yin and yang and disease is caused by an imbalance leading to a blockage in the flow of qi..
Among the major assumptions in TCM are that health is achieved by maintaining the body in a "balanced state" and that disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi. In traditional Chinese medicine, the vital energy or life force proposed to regulate a person's spiritual, emotional, mental, and physical health and to be influenced by the opposing forces of yin and yang. (or vital energy) and of blood along pathways known as meridians. TCM practitioners typically use herbs, acupuncture.
Treatments in TCM : are typically tailored to the subtle patterns of disharmony in each patient and are based on an individualized diagnosis. The diagnostic tools differ from those of conventional medicine
Herbs
Herbs : definition When a plants or products made from them, can have a powerful impact on our bodies and when plants are used for such effects rather than as food, they are called Herbs
Examples of some Useful Herbal Products Echinacea immune stimulant Kava anxiolytic Saw Palmetto Ginkgo BPH circulation Black cohosh menopause symptoms Milk Thistle liver Green tea stimulant (antioxidant) Ginger nausea Cranberry UTI prevention Chamomile Fever Few indigestion migraine Yohimbe erectile dysfunction St. John s Wort mild/mod depression Valerian Sleep Disorders Hawthorn Soy heart/circulation menopause symptoms Garlic Hyperlipidemia
Challenges of Herbal Medicines & Adverse effects: Safety is assumed, not proven e.g Cabbage causes goiter,some plants are poisonous ( Herb Tea ) Lack of product standardization Contamination with drugs, heavy metals Allergic reactions Inherent toxicity Interactions with drug Replacing proven therapies
Complementary and Alternative Medicine Garlic Decreases platelet aggregation over a period of 3-7 days Bacterialcidal but no evidence of an effect on viruses or fungi Fights Salmonella and staph Terpenoid effect- membrane disruption Essential oil has determined it has cancer defending properties
Probiotics: definitions live microorganisms which when administered in adequate amounts confer a health benefit on the host e.g. Lactobacillus sp. Sources: breastmilk, barley, bran and whole grains, legumes, such as beans; vegetables such as leeks, onions, asparagus, greens such as chicory, spinach, burdock, fruits such as bananas, berries Doses: 1 2 grams daily (adults) Side effects: flatulence, diarrhea, allergies