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Would you call a balneotherapist when your face breaks out? How about a reflexologist when your asthma flares? No matter how weird they might seem, alternative medical practices are gaining traction in the U.S.

We’ve put together a guide to some of the most popular alternative physical therapies working their way into the mainstream.

In general, the term “alternative therapy” refers to any health treatment not standard in Western medical practice. When used alongside standard medical practices, alternative approaches are referred to as “complementary” medicine.

Beyond that, complementary and alternative therapies are difficult to define, largely because the field is so diverse. It encompasses diet and exercise changes, hypnosis, chiropractic adjustment, and poking needles into a person’s skin (aka acupuncture), among other treatments.

The benefits 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 checking them out.

In 2008 (the most recent valid data we could find),more than 38 percent of American adults used some form of alternative medicine, according to the NIH. Here are some of the practices that are changing the way Americans approach medical care.

Naturopathic medicine is premised on the healing power of nature, and it’s a broad branch of alternative medicine.

Naturopathic doctors are trained in both conventional and alternative medicines. They seek to understand the cause of a condition by exploring its mental, physical, and spiritual manifestations in a given patient.

Naturopathy typically involves a variety of treatment techniques, including nutrition, behavioral changes, herbal medicine, homeopathy, and acupuncture.

1. Acupressure

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 a handful of studies have found positive results.

In 2013, researchers worked with a group of adolescents suffering from insomnia. They found that acupressure helped them fall asleep faster and get deeper sleep. Carotenuto M, et al. (2013). Acupressure therapy for insomnia in adolescents: a polysomnographic study. DOI: 10.2147/NDT.S41892

Acupressure may also offer pain relief. In 2014, researchers did a review of existing studies and found that acupressure could relieve a range of issues, including pesky lower back pain, headaches, and even labor pain. Chen YW, et al. (2014). The effectiveness of acupressure on relieving pain: a systematic review. DOI: 10.1016/j.pmn.2012.12.005

There may even be some mental health benefits as well. A 2015 review of 39 studies found that acupressure provided immediate relief for people experiencing anxiety. Au DW, et al. (2015). Effects of acupressure on anxiety: a systematic review and meta-analysis. DOI: 10.1136/acupmed-2014-010720

Another study that same year found that acupressure 3 times per week for a month was able to assuage anxiety, depression, and stress for dialysis patients. Hmwe NT, et al. (2015). The effects of acupressure on depression, anxiety and stress in patients with hemodialysis: a randomized controlled trial. DOI: 10.1016/j.ijnurstu.2014.11.002

2. Acupuncture

Though reading about this practice of traditional Chinese medicine may immediately bring sharp needles to mind, the term actually describes stimulating specific points on the body.

The best-known variety consists of penetrating the skin with thin needles controlled by a practitioner, but electrical stimulation can also be used.

We have known for a while that acupuncture can have positive results on PMS, insomnia, and many types of chronic pain, like neck pain and osteoarthritis. Habek D, et al. (2002). Using acupuncture to treat premenstrual syndrome. DOI: 10.1007/s00404-001-0270-7 Cao H, et al. (2009). Acupuncture for treatment of insomnia: A systematic review of randomized controlled trials. DOI: 10.1089/acm.2009.0041Vickers AJ, et al. (2012). Acupuncture for chronic pain: individual patient data meta-analysis. DOI:10.1001/archinternmed.2012.3654

Newer research looks promising as well. For example, a 2016 study with 2,349 participants found that acupuncture may be effective for tension or chronic headaches, though more trials are needed to be sure. Linde K, et al. (2016). Acupuncture for the prevention of tension-type headache. DOI: 10.1002/14651858.CD007587.pub2

Thinking it’s the placebo effect? Not so. A 2017 metanalysis confirmed that the positive outcomes of acupuncture could not be explained by the placebo effect alone, and it’s therefore a reasonable treatment option for those who have to deal with chronic pain on the regular. Vickers AJ, et al. Acupuncture for chronic pain: Update of an individual patient data meta-analysis. DOI: 10.1016/j.jpain.2017.11.005

3. Aromatherapy

Aromatherapy uses essential oils — highly concentrated extracts from the roots, leaves, seeds, or blossoms of plants — to promote healing. It’s a practice that can be traced back to at least 5,000 years ago. Stefiltisch W. (2017). Aromatherapy — From traditional and scientific evidence into clinical practice. DOI: 10.1055/s-0043-116476

The oils can be inhaled using a diffuser, or diluted in a carrier oil and massaged into the skin. Some are used to treat inflammation or infections while others are used to promote relaxation and calm.

In clinical settings, researchers have focused on aromatherapy for anxiety, depression, pain relief, nausea, and insomnia. In a 2017 study, for example, aromatherapy with lavender was found to promote sleep and reduce anxiety for patients with heart disease. Karadag E, et al. (2017). Effects of aromatherapy on sleep quality and anxiety of patients. DOI: 10.1111/nicc.12198

In 2017, researchers rounded up a group of female nurses working night shifts, curious to see if aromatherapy massage would help their sleep. It turns out, after massage with sweet marjoram essential oil, and drinking a glass of warm water, their sleep quality improved. Chang YY, et al. (2017). The effects of aromatherapy massage on sleep quality of nurses on monthly rotating night shifts.DOI: 10.1155/2017/3861273

If you’ve heard inhaling scents can help with stress, there may be something to that. Though more research is needed in this area, a 2013 study found that pregnant women who inhaled linalool (found in mint) and linalyl acetate (found in lavender) felt calmer after just 5 minutes. Igarashi T. (2013). Physical and psychologic effects of aromatherapy inhalation on pregnant women: A randomized controlled trial. DOI: 10.1089/acm.2012.0103

Note: It’s important to consider others in the area when using aromatherapy. Some essential oils can be dangerous for pregnant women, children, or pets. Do not apply them directly to skin, and avoid prolonged exposure without ventilation.

4. Ayurvedic medicine

Also known as Ayurveda, this modality 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.

There are several studies that show positive results for specific Ayurvedic practices, like taking turmeric for inflammation, using a Neti pot to clear the sinuses (called nasal irrigation), or swishing coconut oil in your mouth to pull out bacteria (known as oil pulling). He Y, et al (2015). Curcumin, inflammation, and chronic diseases: How are they linked?DOI: 10.3390/molecules20059183 Chen JR, et al. (2014). The effectiveness of nasal saline irrigation (seawater) in treatment of allergic rhinitis in children. DOI: 10.1016/j.ijporl.2014.04.026 Shanbhag VK. (2017). Oil pulling for maintaining oral hygiene – A review. DOI: 10.1016/j.jtcme.2016.05.004

And we can’t forget about yoga, which is mentioned in Ayurvedic texts. In the latest research available, yoga has been shown time and time again to address a range of mental and physical health issues, like anxiety, depression, high blood pressure, and insomnia, among Ross A, et al. (2014). National survey of yoga practitioners: Mental and physical health benefits. DOI: 10.1016/j.ctim.2013.04.001 Hagins M, et al. (2013). Effectiveness of yoga for hypertension: systematic review and meta-analysis. DOI: 10.1155/2013/649836

5. Balneotherapy

Sometimes confused with hydrotherapy, balneotherapy involves the use of water for therapeutic purposes, and it dates as far back as 1700 BCE. It’s a popular course of treatment in several European countries to this day — think thermal baths in Hungary. (Yes, please.) Galvez I, et al. (2018). Balneotherapy, immune system, and stress response: A hormetic strategy? DOI: 10.3390/ijms19061687

It’s based on the idea that water benefits the skin and might treat a range of conditions from acne to pain, swelling to anxiety. Practitioners use mudpacks, douches, long soaks, and wraps in attempts to reap agua’s many rewards. For this reason, it’s often called “spa therapy.”

Balneotherapy has been studied for its effects on chronic pain, with some positive results. For example, a 2015 study found that spa therapy combined with exercise could ease low back pain in the long-term. Worth noting, though, the researchers said better studies were needed. Karagulle M, et al. (2015). Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence. DOI: 10.1007/s10067-014-2845-2

Proponents of the therapy cite findings that mineral water might boost people’s immune systems or aid arthritis, but so far that research remains inconclusive.

6. Biofeedback

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. Relaxation seems to be a key component, as most people who benefit from the practice have conditions that are caused by, or exacerbated by, stress.

During biofeedback, you become more self-aware of how you react physically to stress, exercise, or emotions. In turn, you can learn to reduce negative effects on your body and health.

In 2017, researchers gathered 451 records on biofeedback and sports performance. Of all the papers, they found seven to review in-depth. The results were fascinating: 85 percent of athletes improved their performance by messing with their own heart rate using biofeedback. Jimenez MS, et al. (2017). Effect of heart rate variability biofeedback on sport performance, a systematic review. DOI: 10.1007/s10484-017-9364-2

But even if you’re not an athlete, there’s good news. A 2016 study showed that biofeedback can be an effective treatment for headaches, which 90 percent of people get at least once a year. Sesic A, et al. (2016). Biofeedback training and tension-type headache. https://www.ncbi.nlm.nih.gov/pubmed/27333731

7. Chiropractic medicine

Chiropractic work is widely accepted in the medical community, and thus qualifies more as a “complementary” medicine than alternative. The practice focuses on the musculoskeletal and nervous systems, treating issues 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 joint movement becomes restricted when surrounding tissues are injured either during a single event, like tweaking a muscle during a weight-lifting session or through repetitive stress, like sitting with poor posture for extended periods.

Chiropractic adjustments are intended to restore mobility and loosen the muscles, allowing tissues to heal and the pain to resolve. Studies generally affirm its efficacy, with research suggesting it can improve conditions like neck pain or low back pain. Bryans R, et al. (2014). Evidence-based guidelines for the chiropractic treatment of adults with neck pain. DOI:10.1016/j.jmpt.2013.08.010 Goertz CM, et al. (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. DOI: 10.1001/jamanetworkopen.2018.0105

8. Homeopathy

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. Bellavite P. (2015). Homeopathy and integrative medicine: keeping an open mind. DOI: 10.1007/s12682-014-0198-x

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. These treatments are called “remedies.”

There’s some clinical evidence that homeopathy is more effective than placebos for some things, like anxiety in mice. However, that same year, another study on humans showed that it was not effective for treatment of anxiety. The battle wages on. Lakshimpathy PR, et al. (2012). Anxiolytic effect of homeopathic preparation of Pulsatilla nigricans in Swiss albino mice. DOI: 10.1016/j.homp.2012.05.003 Paris A, et al. (2012). Effect of gelsemium 5CH and 15CH on anticipatory anxiety: a phase III, single-centre, randomized, placebo-controlled study. DOI: 10.1111/j.1472-8206.2011.00993.x

Some remedies (such as arnica for bruising) show promise. But since remedies are individualized for each patient, it’s difficult to examine effectiveness. More research is needed.

Until we know more, it may not be worth messing around with the more serious stuff, like cancer or chronic conditions. In fact, the NIH says, “there is no reliable evidence that homeopathy is effective for any health condition.”

9. Reflexology

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. Embong NH, et al. (2015). Revisiting reflexology: Concept, evidence, current practice, and practitioner training. DOI: 10.1016/j.jtcme.2015.08.008

For example, applying pressure to a spot on the arch of the foot is believed to benefit bladder function. A person can use reflexology on themselves or enlist the help of a reflexologist.

People around the world use this therapy to complement conventional treatments for conditions including anxiety, cancer, diabetes, kidney function, and asthma.

Some studies have found that reflexology can improve depression and hospital anxiety in patients with cardiovascular disease, quell nausea and fatigue brought on by chemotherapy, and reduce stress in general. Bahrami T, et al. (2019). The effect of foot reflexology on hospital anxiety and depression in female older adults: a randomized controlled trial. https://www.ncbi.nlm.nih.gov/pubmed/31489059 Ozdelikara A, et al. (2017). The effect of reflexology on chemotherapy-induced nausea, vomiting, and fatigue in breast cancer patients. DOI: 10.4103/apjon.apjon_15_17 Payrau B, et al. (2017). Fasciatherapy and reflexology compared to hypnosis and music therapy in daily stress management. https://www.ncbi.nlm.nih.gov/pubmed/28912904

If you’re going to try out reflexology, be sure to work with a professional you trust. If performed incorrectly, reflexology can cause pain and bruises. Embong NH, et al. (2017). Perspectives on reflexology: A qualitative approach. DOI: 10.1016/j.jtcme.2016.08.008

10. Reiki

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 well-being. For the most part, there’s no regulation for Reiki practitioners.

A 2015 analysis found that Reiki may provide pain and anxiety relief for those with cancer, post-operative pain, and other ailments. It’s important to note that out of 49 articles examined, only 7 contained data the researchers considered legit, which means more studies are needed. Thrane S, et al. (2014). Effect of reiki therapy on pain and anxiety in adults: An in-depth literature review of randomized trials with effect size calculations. DOI: 10.1016/j.pmn.2013.07.008

2017 studies echoed similar sentiments. A review of 13 studies found that Reiki is more effective than placebo for pain relief, anxiety, depression, self-esteem, and overall quality of life. McManus, DE. (2017). Reiki is better than placebo and has broad potential as a complementary health therapy.DOI: 10.1177/2156587217728644

So, what did we learn, kids? For one thing, the field of alternative medicine is vast. If it seems like new therapies and studies are cropping up all the time, it’s because they are.

It’s an evolving area and more research in all of these therapies is needed. That said, integrating a handful of these into your routine may have solid benefits to your health. There’s a reason some of these have been around for thousands of years, after all.

The bottom line is this: We believe in doing what works, as long as you’ve consulted with a doctor or practitioner you can rely on. You may need a combination of Western medicine and complementary therapies to heal.

As always, do your research and listen to your body — no one knows it better than you do.