Few people might think to call a balneotherapist when their face breaks out or a reflexologist when asthma flares. But no matter how weird they might seem, alternative medical practices are gaining traction in the U.S. So we’ve put together a guide to some of the most popular alternative physical therapies working their way into the mainstream.
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In general, the term “alternative therapy” refers to any health treatment not standard in Western medical practice. Beyond that, complementary and alternative therapies are difficult to define, largely because the field is so diverse; it encompasses practices spanning diet and exercise changes, hypnosis, chiropractic adjustment, and poking needles into a person’s skin (aka acupuncture). Technically, “alternative” treatments are used in place of conventional medicine; when used alongside standard medical practices, alternative approaches are referred to as “complementary” medicine.
The field of alternative therapies is diverse: It encompasses practices spanning diet and exercise changes, hypnosis, chiropractic adjustment, and acupuncture.
The benefits (or lack thereof) of alternative therapies are hotly contested. More research is needed to determine the efficacy of nearly all of these practices, but that hasn’t stopped people from engaging in them: In 2008 (the most recent valid data we could find), more than 38 percent of American adults used some form of alternative medicine. Follow along as we sort through the practices that are changing the way Americans approach medical care.
Guide to Alternative & Complementary Medicines
Acupressure is similar in practice to acupuncture (see below), only no needles are involved. Practitioners use their hands, elbows, or feet to apply pressure to specific points along the body’s “meridians.” According to the theory behind acupressure, meridians are channels that carry life energy (qi or ch’i) throughout the body. The reasoning holds that illness can occur when one of these meridians is blocked or out of balance; acupressure is thought to relieve blockages so energy can flow freely again, restoring wellness.
More research is needed, but pilot studies have found positive results: Acupressure might decrease nausea for chemotherapy patients and reduce anxiety in people scheduled to have surgery Acupressure for nausea: results of a pilot study. Dibble, SL, Chapman, J., Mack, KA, et al. Institute for Health and Aging, University of California. Oncology and Nursing Forum, 2000 Jan-Feb;27(1):41-7 Effect of acupressure on preoperative anxiety: a clinical trial. Valiee, S., Bassampour, SS, Nasrabadi, AN, et al. Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Iran. Journal of Perianesthesia Nursing, 2012 Aug;27(4):259-66 .
Though “acupuncture” may immediately bring needles to mind, the term actually describes an array of procedures that stimulate specific points on the body. The best-known variety consists of penetrating the skin with thin needles controlled by a practitioner or electrical stimulation, and it’s currently used by millions of Americans each year.
Despite its popularity, controversy over acupuncture’s efficacy abounds. Some studies find it helpful for chronic pain and depression, but evidence on all counts is mixed Acupuncture and dry-needling for low back pain. Furlan, AD, van Tulder, MW, Cherkin, DC, et al. Institute for Work & Health, Canada. Cochrane Database Systems Review, 2005 Jan 25;(1):CD001351 The effectiveness of acupuncture in treating chronic non-specific low back pain; a systematic review of the literature. Hutchinson, AJ, Ball, S., Andrews, JC, et al. Journal of Orthopedic Surgery and Research, 2012 Oct 30;7(1):36 Acupuncture for depression. Smith, CA, Hay, PP, Macpherson, H. Centre for Complementary Medicine Research, The University of Western Sydney. Cochrane Database Systems Review, 2010 Jan 20;(1):CD004046 .
Aromatherapy uses essential oils (concentrated extracts from the roots, leaves, seeds, or blossoms of plants) to promote healing. The oils can be inhaled, massaged into the skin or (in rare cases) taken by mouth, and each has a specific purpose: Some are used to treat inflammation or infections; others are used to promote relaxation.
Studies suggest aromatherapy might reduce pain, depression, and anxiety, but more research is needed to fully determine its uses and benefits Use of aromatherapy with hospice patients to decrease pain, anxiety, and depression and to promote an increased sense of well-being. Louis, M., Kowalski, SD. Department of Nursing, University of Nevada. American Journal of Hospice and Palliative Care, 2002 Nov-Dec;19(6):381-6 The effects of aromatherapy on pain, depression, and life satisfaction of arthritis patients. Kim, MJ, Nam, ES, Paik, SI. College of Nursing, the Catholic University of Korea. Taehan Kanho Hakhoe Chi, 2005 Feb;35(1):186-94 .
4. Ayurvedic Medicine
Also known as Ayurveda, Ayurvedic medicine originated in India and has been around for thousands of years. Practitioners use a variety of techniques, including herbs, massage, and specialized diets, with the intent of balancing the body, mind, and spirit to promote overall wellness.
Studies of Ayurveda are few and far between (perhaps because the practice includes such a wide variety of treatments), so it’s difficult to determine how effective it is as a treatment system (But the fact that the treatment system has persisted for so many years suggests it's got something going for it.).
Also known as hydrotherapy, balneotherapy involves the use of water for therapeutic purposes, and it dates as far back as 1700 B.C.E. It’s based on the idea that water benefits the skin and might treat a range of conditions from acne to pain, swelling, and anxiety; practitioners use mudpacks, douches, and wraps in attempts to reap agua’s rewards.
Proponents of the therapy cite findings that water might boost people’s immune systems, though research on balneotherapy’s effectiveness remains inconclusive Effectiveness of aquatic exercise and balneotherapy: a summary of systematic reviews based on randomized controlled trials of water immersion therapies. Kamjoka, H., Tsutani, K., Okuizumi, H., et al. Faculty of Regional Environment Science, Tokyo University of Agriculture. Journal of Epidemiology, 2010;20(1):2-12. Epub 2009 Oct 31 .
Biofeedback techniques allow people to control bodily processes that normally happen involuntarily—such as heart rate, blood pressure, muscle tension, and skin temperature—in order to improve conditions including high blood pressure, headaches, and chronic pain. Patients work with a biofeedback therapist to learn these relaxation techniques and mental exercises. In initial sessions, electrodes are attached to the skin to measure bodily states, but eventually the techniques can be practiced without a therapist or equipment.
Researchers still aren’t sure how or why biofeedback works—but a lot of research suggests it does work Audiovisual biofeedback improves diaphragm motion reproducibility in MRI. Kim, T., Pollock, S., Lee, D., et al. Radiation Physics Laboratory, Sydney Medical School, University of Sydney. Medical Physics, 2012 Nov;39(11):6921-8. doi: 10.1118/1.4761866 Heart rate variability biodfeedback decreases blood pressure in prehypertensive subjects by improving autonomic function and baroreflex. Lin, G., Xiang, Q., Fu, X., et al. Department of Physiology, Zhongshan School of Medicine, Sun Yat-sen University, China. Journal of Alternative and Complementary Medicine, 2012 Feb;18(2):143-52 The effect of heart rate variability biofeedback on performance psychology of basketball players. Paul, M. and Garg, K. Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, India. Applied Psychophysiology and Biofeedback, 2012 Jun;37(2):131-44 . Relaxation seems to be a key component, as most people who benefit from the practice have conditions that are caused or exacerbated by stress.
Chiropractic is pretty widely accepted in the medical community, and thus qualifies more as a “complementary” medicine than an alternative one. The practice focuses on disorders of the musculoskeletal and nervous systems, including pain in the back, neck, joints, arms, legs, and head. The most common procedure performed by chiropractors is “spinal manipulation” (aka an “adjustment”), which involves applying controlled force (typically the chiropractor’s hands) to joints that have become “hypomobile.” The idea is that joints’ movements become restricted when surrounding tissues are injured either during a single event (tweaking a muscle during a weight-lifting session) or through repetitive stress (sitting with poor posture for extended periods). Chiropractic adjustments of the affected area are intended to restore mobility and loosen the muscles, allowing the tissues to heal and the pain to resolve.
Studies of chiropractic generally affirm its efficacy, with research suggesting the practice can decrease pain and improve physical functioning Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: the results of a pragmatic randomized comparative effectiveness study. Goertz, CM, Long, CR, Hondras, MA, et al. Palmer Center for Chiropractic Research. Spine, 2012 Oct 10 A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study. Hurtwitz, EL, Morgenstern, H., Harber, P., et al. Department of Epidemiology, University of California- Los Angeles School of Public Health. Spine, 2002 Oct 15;27(20):2193-204 .
Homeopathy functions in much the same way as a vaccine: It’s based on the principle of treating “like with like,” meaning a substance that causes adverse reactions when taken in large doses can be used—in small amounts—to treat those same symptoms. (This concept is sometimes used in conventional medicine, as well; for example, Ritalin is a stimulant used to treat patients with ADHD.) Homeopaths gather extensive background information on patients before prescribing a highly diluted substance, usually in liquid or tablet form, to jumpstart the body’s natural systems of healing.
There’s some clinical evidence that homeopathy is more effective than placebos, though more research is needed to determine its efficacy Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group. Cucherat, M., Haugh, MC, Gooch M., et al. Department of Clinical Pharmacology, Hospitals of Lyon and University Claude Bernard, France. European Journal of Clinical Pharmacology, 2000 Apr;56(1):27-33 .
Naturopathic medicine is premised on the healing power of nature. Naturopathic doctors are trained in both conventional and alternative medicines, and seek to understand the cause of a condition by exploring its mental, physical, and spiritual manifestations in a given patient Naturopathic physicians: holistic primary care and integrative medicine specialists. Litchy, AP. National College of Natural Medicine, Helfgott Research Institute, Oregon. Journal of Dietary Supplements, 2011 Dec;8(4):369-77 . Naturopathy typically involves a variety of treatment techniques including nutrition, behavioral changes, herbal medicine, homeopathy, and acupuncture.
Because it involves so many different therapies, it’s difficult to design studies that specifically target naturopathy’s effectiveness. That said, one study that evaluated the practice for low back pain found positive results Naturopathic care for chronic low back pain: a randomized trial. Szczurko, O., Cooley, K., Busse, JW, et al. Division of Clinical Epidemiology, Canadian College of Naturopathic Medicine. PLoS One, 2007 Sep 19;2(9):e919 .
Reflexology involves applying pressure to specific areas on the feet, hands, or ears. The theory is that these points correspond to different body organs and systems; pressing them is believed to positively affect these organs and a person’s overall health. (For example, applying pressure to a spot on the arch of the foot is believed to benefit bladder function.) A person can either use reflexology on her or his self, or enlist the help of a reflexologist. Millions of people around the world use the therapy to complement conventional treatments for conditions including anxiety, cancer, diabetes, kidney function, and asthma.
Some studies have found that reflexology can improve respiratory function in breast cancer patients, reduce fatigue, and improve sleep—but other studies have reached less definitive conclusions Health-Related Quality-of-Life Outcomes: A Reflexology Trial With Patients With Advanced-Stage Breast Cancer. Wyatt, G., Sikorskii, A., Rahbar, MH, et al. College of Nursing, Michigan State University in East Lansing. Oncology Nursing Forum, 2012 Nov 1;39(6):568-77 Effects of foot reflexology on fatigue, sleep and pain: a systematic review and meta-analysis. Lee, J., Han, M., Chung, Y., et al. Department of Nursing, Christian College of Nursing, Korea. Journal of Korean Academy of Nursing, 2011 Dec;41(6):821-33 Reflexology: an update of a systematic review of randomized clinical trials. Ernst, E., Posadzki, P., Lee, MS. Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth. Maturitas, 2011 Feb;68(2):116-20. Epub 2010 Dec 15 .
Reiki is a form of energy healing based on the idea that a “life force energy” flows through everyone’s body. According to this philosophy, sickness and stress are indications that life force energy is low, while energy, health, and happiness signify a strong life force. In a Reiki session, a practitioner seeks to “transfer” life energy to the client by placing their hands lightly on the client’s body or a slight distance away from the body (Reiki can also be performed long-distance). The purpose is to promote relaxation, speed healing, reduce pain, and generally improve the client’s wellbeing. For the most part, there’s no regulation for Reiki practitioners.
Studies of the practice’s efficacy are varied: Some find therapeutic touch to be an effective form of treatment; some don’t Healing touch for older adults with persistent pain. Wardell, DW, Decker, SA, Engebretson, JC. School of Nursing, the University of Texas Health Science Center at Houston. Holistic Nursing Practice, 2012 Jul-Aug;26(4):194-202 Effects of reiki in clinical practice: a systematic review of randomized clinical trials. Lee, MS, Pittler, MH, Ernst, E. Complementary Medicine Peninsula Medical School, Universities of Exeter & Plymouth. International Journal of Clinical Practice, 2008 Jun;62(6):947-54. Epub 2008 Apr 10 .
Disclaimer: The information above is only preliminary. It's always advisable to contact a medical professional before undergoing any form of conventional or alternative medical treatment.
Have you tried any of these therapies? Got any others to add? Share in the comments below, or get in touch with the author on Twitter @LauraNewc.
Originally posted November, 2012, updated April 2014