Complementary and alternative medicine (CAM), more recently known as integrative health or integrative medicine, is a diverse field comprising numerous treatments and practitioners of various levels of training. This review defines several of the main CAM modalities and reviews some of the research relevant to their clinical application. The goal is to provide healthcare providers with a basic understanding of CAM to start the incorporation of proven treatments into their clinical practice as well as guide them to working with CAM providers; ultimately, such knowledge is a fundamental part of a collaborative approach to optimal patient health and wellness.
KemperKJVohraSWallsR. Task Force on Complementary and Alternative Medicine; Provisional Section on Complementary, Holistic, and Integrative Medicine; American Academy of Pediatrics. The use of complementary and alternative medicine in pediatrics. Pediatrics. 2008;122:1374‐1378.
2.
TindleHADavisRBPhillipsRSEisenbergDM. Trends in use of complementary and alternative medicine by US adults: 1997–2002. Altern Ther Health Med. 2005;11:42‐49.
3.
KellyJPKaufmanDWKelleyKRosenbergLAndersonTEMitchellAA. Recent trends in use of herbal and other natural products. Arch Intern Med. 2005;165:281‐286.
4.
KaufmanDWKellyJPRosenbergLAndersonTEMitchellAA. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA. 2002;287:337‐344.
5.
SawniA. Attention‐deficit/hyperactivity disorder and complementary/alternative medicine. Adolesc Med State Art Rev. 2008;19:313‐326, xi.
6.
MarkJD. Integrative medicine and asthma. Pediatr Clin North Am. 2007;54:1007‐1023, xii.
7.
AndreescuCMulsantBHEmanuelJE. Complementary and alternative medicine in the treatment of bipolar disorder—a review of the evidence. J Affect Disord. 2008;110:16‐26.
8.
HollanderJMMechanickJI. Complementary and alternative medicine and the management of the metabolic syndrome. J Am Diet Assoc. 2008;108:495‐509.
9.
PittlerMHErnstE. Complementary therapies for neuropathic and neuralgic pain: systematic review. Clin J Pain. 2008;24:731‐733.
10.
National Center for Complementary and Alternative Medicine. National Institutes of Health. Available at: http://www.nccam.nih.gov. Accessed March 2, 2009.
11.
The International Center for Reiki Training. Available at: http://www.reiki.org. Accessed March 2, 2009.
12.
Nield‐AndersonLAmelingA. The empowering nature of Reiki as a complemntary therapy. Holist Nurs Pract. 2000;14:21‐29.
13.
LeeMSPittlerMHErnstE. Effects of reiki in clinical practice: a systematic review of randomized clinical trials. Int J Clin Pract. 2008;62:947‐954.
SoPSJiangYQinY. Touch therapies for pain relief in adults. Cochrane Database Syst Rev. 2008;4:CD006535.
16.
FarnsworthNRAkereleOBingelASSoejartoDDZhengangG. Medicinal plants in therapy. Bull World Health Organ. 1985;63:965‐981.
17.
EisenbergDMDavisRBEttnerSL. Trends in alternative medicine use in the United States, 1990‐1997. JAMA. 1998;280:1569‐1575.
18.
EisenbergDMKesslerRCFosterCNorlockFECalkinsDRDelbancoTL. Unconventional medicine in the United States: prevalence, cost, and patterns of use. N Engl J Med. 1993;328:246‐252.
19.
BentS. Herbal medicine in the United States: review of efficacy, safety, and regulation: grand rounds at University of California, San Francisco Medical Center. J Gen Intern Med. 2008;23:854‐859.
20.
YeungKSGubiliJCassilethB. Evidence‐based botanical research: applications and challenges. Hematol Oncol Clin North Am. 2008;22:661‐70, viii.
21.
BardiaANislyNLZimmermanBGryzlakBMWallaceRB. Use of herbs among adults based on evidence‐based indications: findings from the National Health Interview Survey. Mayo Clin Proc. 2007;82:561‐566.
JacobsJGloydSSGaleJLJiménezMCrothersD. Treatment of acute childhood diarrhea with homeopathic medicine: a randomized clinical trial in Nicaragua. Pediatrics. 1994;93:719‐725.
25.
ParisAGonnetNChaussardC. Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase III monocentre randomized placebo controlled study. Br J Clin Pharmacol. 2008;65:180‐187.
26.
ZabolotnyiDIKneisKCRichardsonA. Efficacy of a complex homeopathic medication (Sinfrontal) in patients with acute maxillary sinusitis: a prospective, randomized, double‐blind, placebo‐controlled, multicenter clinical trial. Explore (NY). 2007;3:98‐109.
27.
SchneiderCSchneiderBHanischJvan HaselenR. The role of a homoeopathic preparation compared with conventional therapy in the treatment of injuries: an observational cohort study. Complement Ther Med. 2008;16:22‐27.
28.
KeilTWittCMRollS. Homoeopathic versus conventional treatment of children with eczema: a comparative cohort study. Complement Ther Med. 2008;16:15‐21.
29.
CoulterMKDeanME. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. Cochrane Database Syst Rev. 2007;4:CD005648.
30.
AstinJAShapiroSLEisenbergDMForysKL. Mind–body medicine: state of the science, implications for practice. J Am Board Fam Pract. 2003;16:131‐147.
31.
OspinaMBBondKKarkhanehM. Meditation practices for health: state of the research. Evidence Report/Technology Assessment. 2007;155:1‐263.
32.
OspinaMBBondKKarkhanehM. Clinical trials of meditation practices in health care: characteristics and quality. J Alt Comp Med. 2008;14:1199‐1213.
33.
InnesKEVincentHKTaylorAG. Chronic stress and insulin resistance‐related indices of cardiovascular disease risk, part I: neurophysiological responses and pathological sequelae. Alt Ther Health Med. 2007;13:46‐52.
34.
InnesKEVincentHKTaylorAG. Chronic stress and insulin resistance‐related indices of cardiovascular disease risk, part 2: a potential role for mind–body therapies. Alt Ther Health Med. 2007;13:44‐51.
35.
RainforthMVSchneiderRHNidichSIGaylord‐KingCSalernoJWAndersonJW. Stress reduction programs in patients with elevated blood pressure: a systematic review and meta‐analysis. Curr Hypertens Rep. 2007;9:520‐528.
36.
AndersonJWLiuCKryscioRJ. Blood pressure response to transcendental meditation: a meta‐analysis. Am J Hypertenstion. 2008; 21:310‐316.
37.
MoravecCS. Biofeedback therapy in cardiovascular disease: rationale and research overview. Cleveland Clinic J Med. 2008; 75(supp 2):S35‐S38.
38.
MontiDASufianMPetersonC. Potential role of mind–body therapies in cancer survivorship. Cancer. 2008;112(11 suppl):2607‐2616.
39.
NestoriucYMartinARiefWAndrasikF. Biofeedback treatment for headache disorders: a comprehensive efficacy review. Appl Psychophysiol Biofeedback. 2008;33:125‐140.
40.
TurkDCSwansonKSTunksER. Psychological approaches in the treatment of chronic pain patients—when pills, scalpels, and needles are not enough. Can J Psychiatry. 2008;53:213‐223.
41.
RamaratnamSBakerGAGoldsteinLH. Psychological treatments for epilepsy. Cochrane Database Syst Rev. 2008;3:CD002029.
ToremMS. Mind–body hypnotic imagery in the treatment of auto‐immune disorders. Am J Clin Hypnosis. 2007;50:157‐170.
44.
JormAFMorganAJHetrickSE. Relaxation for depression. Cochrane Database Syst Rev. 2008;4:CD007142.
45.
ManzoniGMPagniniFCastelnuovoGMolinariE. Relaxation training for anxiety: a ten‐years systematic review with meta‐analysis. BMC Psychiatry. 2008;8:41.
46.
KearneyDJBrown‐ChangJ. Complementary and alternative medicine for IBS in adults: mind–body interventions. Nat Clin Pract: Gastroenterol Hepatol. 2008;5:624‐636.
47.
SimopoulosA. The Mediterranean diets: what is so special about the diet of Greece? The scientific evidence. J Nutr. 2001;131(11 suppl):3065S‐3073S.
48.
De LorgerilMSalenPMartinJLMonjaudIDelayeJMammelleN. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complication after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99:779‐785.
49.
MitrouPKipnisVThiébautAC. Meditarranean dietary pattern and prediction of all‐cause mortality in a US population: Results from the NIH‐AARP Diet and Health Study. Arch Intern Med. 2007;167:2461‐2468.
50.
KliglerBLeeR. Integrative Medicine: Principles for Practice. New York, NY: McGraw‐Hill Co; 2004;141‐142.
51.
JenkinsDJWoleverTMTaylorRH. Glycemic index of foods: a physiological basis of carbohydrate exchange. Am J Clin Nutr. 1981;34:362‐366.
SalmeronJMansonJEStampferMJColditzGAWingALWillettWC. Dietary fiber, glycemic load, and risk of non‐insulin‐dependent diabetes mellitus in women. JAMA. 1997;277:472‐477.
54.
ThomasDElliottEJBaurL. Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev. 2007;3:CD005105.
55.
BarnardRJAronsonWJTymchukCNNgoTH. Prostate cancer: another aspect of the insulin‐resistance syndrome?Obes Rev. 2002;3:303‐308.
56.
CovingtonMB. Omega‐3 fatty acids. Am Fam Physician. 2004; 70:133‐140.
57.
MenteAde KoningLShannonHSAnandSS. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Int Med. 2009;169:659‐669.
58.
SimopoulosA. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(3 suppl):560S‐5696S.
59.
AssendelftWJMortonSCYuEISuttorpMJShekellePG. Spinal manipulative therapy for low back pain. Cochrane Database Syst Rev. 2004;1:CD00044.
60.
FerreiraMLFerreiraPHLatimerJHerbertRMaherCG. Efficacy of spinal manipulative therapy for low back pain of less than three months’ duration. J Manipulative Physiol Ther. 2003;26:593‐601.
61.
ChouRHuffmanLH. American Pain Society; American College of Physicians. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147:492‐504.
62.
ErnstE. Chiropractic spinal manipulation for neck pain: a systematic review. J Pain. 2003;4:417‐421.
63.
RubinsteinSMLeboeuf‐YdeCKnolDLde KoekkoekTEPfeifleCEvan TulderMW. The benefits outweigh the risks for patients undergoing chiropractic care for neck pain: a prospective, multicenter, cohort study. J Manipulative Physiol Ther. 2007;30:408‐418.
64.
BronfortGAssendelftWJEvansRHaasMBouterL. Efficacy of spinal manipulation for chronic headache: a systematic review. J Manipulative Physiol Ther. 2001;24:457‐466.
65.
FurlanADImamuraMDrydenTIrvinE. Massage for low‐back pain. Cochrane Database Syst Rev. 2008;4:CD001929.
66.
LadDV. Ayurvedic Medicine. In: JonasWBLevinJS (eds.). Essentials of Complementary & Alternative Medicine. Baltimore, MD: Lippincott Williams and Wilkins; 1999.
67.
SharmaHChandolaHMSinghGBasishtG. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 1—Ayurveda, the science of life. J Alt Comp Med. 2007;13:1011‐1019.
68.
HathcherHPlanalpRChoJTortiFMTortiSV. Curcumin: from ancient medicine to current clinical trials. Cell Mol Life Sci. 2008;65:1631‐1652.
69.
LeeMSKimJIHaJYBoddyKErnstE. Yoga for menopausal symptoms: a systematic review. Menopause. 2009;16:602‐608.
70.
DiStasioSA. Integrating yoga into cancer care. Clin J Onc Nurs. 2008;12:125‐130.
71.
PilkingtonKKirkwoodGRampesHRichardsonJ. Yoga for depression: the research evidence. J Affec Disord. 2005;89:13‐24.
72.
LaoL. Traditional Chinese Medicine. In: JonasWBLevinJS (eds.). Essentials of Complementary and Alternative Medicine. Baltimore, MD: Lippincott Williams and Wilkins; 1999.
73.
BirchSHesselinkJKJonkmanFAHekkerTABosA. Clinical research on acupuncture. Part 1. What have reviews of the efficacy and safety of acupuncture told us so far?J Comp Alt Med. 2004; 10:468‐480.
74.
ManheimerEZhangGUdoffL. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systematic review and meta‐analysis. BMJ. 2008; 336:545‐549.
75.
PilkingtonKKirkwoodGRampesHCummingsMRichardsonJ. Acupuncture for anxiety and anxiety disorders—a systematic literature review. Acupunct Med. 2007;25:1‐10.
76.
WangHQiHWangBS. Is acupuncture beneficial in depression: a meta‐analysis of 8 randomized controlled trials?J Affect Dis. 2008;111:125‐134.
77.
SamuelsNGroppCSingerSROberbaumM. Acupuncture for psychiatric illness: a literature review. Behav Med. 2008;34:55‐64.
78.
WangCde PabloPChenXSchmidCMcAlindonT. Acupuncture for pain relief in patients with rheumatoid arthritis: a systematic review. Arthritis Rheum. 2008;59:1249‐1256.
79.
CheukDKYeungWFWongV. Acupuncture for insomnia. Cochrane Database Syst Rev. 2007;3:CD005472.
80.
YueXWangLHeJWuT. Acupuncture for dysphagia in acute stroke. Cochrane Database Syst Rev. 2008;3:CD006076.
81.
HeLZhouMKZhouD. Acupuncture for Bell’s palsy. Cochrane Database Syst Rev. 2007;4:CD002914.
82.
LawSKLiT. Acupuncture for glaucoma. Cochrane Database Syst Rev. 2007;4:CD006030.
83.
JordanJBTuX. Advances in heroin addiction treatment with traditional Chinese medicine: a systematic review of recent Chinese language journals. Am J Chin Med. 2008;36:437‐447.
84.
Kang LiBGaoL. Tai‐Kang‐Ning, a Chinese herbal medicine formula, alleviates acute heroin withdrawal. Am J Drug Alcohol Abuse. 2008;34:269‐276.
85.
ShiJXuGZLiuTT. A comparative clinical study of the effects of the traditional Chinese medicine Jinniu capsules and lofexidine on acute heroin withdrawal symptoms. Am J Drug Alcohol Abuse. 2008;34:792‐800.
86.
ZhuXProctorMBensoussanAWuESmithCA. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev. 2008;2:CD005288.
87.
ShiJTongYShenJGLiHX. Effectiveness and safety of herbal medicine in the treatment of irritable bowel syndrome: a systematic review. World J Gastroenterol. 2008;14:454‐462.
88.
ChenJWuGLiS. Shengmai (a traditional Chinese herbal medicine) for heart failure. Cochrane Database Syst Rev. 2007;4:CD005052.
89.
LiuJPZhangMWangWYGrimsgaardS. Chinese herbal medicines for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2002;3:CD003642.
90.
TaixiangWMunroAJGuanjianL. Chinese medical herbs for chemotherapy side effects in colorectal cancer patients. Cochrane Database Syst Rev. 2005;1:CD004540.
91.
ZhangMLiuXLiJHeLTripathyD. Chinese medicinal herbs to treat the side‐effects of chemotherapy in breast cancer patients. Cochrane Database Syst Rev. 2007;2:CD004921.
92.
ZengXXYuanYLiuYWuTXHanS. Chinese herbal medicines for hyperthyroidism. Cochrane Database Syst Rev. 2007;2:CD005450.
93.
JunhuaZHongcaiSXiumeiG. Compound Salvia droplet pill, a traditional Chinese medicine, for the treatment of unstable angina pectoris: a systematic review. Med Sci Monit. 2008;12:RA1‐RA7.
94.
WuBLiuMZhangS. Dan Shen agents for acute ischaemic stroke. Cochrane Database Syst Rev. 2007;2:CD004295.
ChenJXHuLS. Traditional Chinese medicine for the treatment of chronic prostatitis in China: a systematic review and meta‐analysis. J Alt Comp Med. 2006;12:763‐739.
100.
ChenXYWuTXLiuGJ. Chinese medicinal herbs for influenza. Cochrane Database Syst Rev. 2007;4:CD004559.
101.
ShiYGuRLiuCNiJWuT. Chinese medicinal herbs for sore throat. Cochrane Database Syst Rev. 2007;3:CD004877.
102.
WuTZhangJQiuYXieLLiuGJ. Chinese medicinal herbs for the common cold. Cochrane Database Syst Rev. 2007;1:CD004782.
103.
WeiJNiJWuT. Chinese medicinal herbs for acute bronchitis. Cochrane Database Syst Rev. 2008;1:CD004560.
104.
GuoXZhouBNishimuraTTeramukaiSFukushimaM. Clinical effect of qigong practice on essential hypertension: a meta‐analysis of randomized controlled trials. J Comp Alt Med. 2008;14:27‐37.
105.
LeeMSChenKWSancierKMErnstE. Qigong for cancer treatment: a systematic review of controlled clinical trials. Acta Oncologica. 2007;46:717‐722.
106.
XinLMillerYDBrownWJ. A qualitative review of the role of qigong in the management of diabetes. J Comp Alt Med. 2007; 13:427‐433.
107.
LeeMSPittlerMHErnstE. External qigong or pain conditions: a systematic review of randomized clinical trials. J Pain. 2007;8:827‐831.
108.
InnesKESelfeTKTaylorAG. Menopause, the metabolic syndrome, and mind–body therapies. Menopause. 2008;15:1005‐1013.
109.
YehGYWangCWaynePMPhillipsRS. The effect of tai chi exercise on blood pressure: a systematic review. Prev Cardiol. 2008; 11:82‐89.
110.
WaynePMKielDPKrebsDE. The effects of Tai Chi on bone mineral density in postmenopausal women: a systematic review. Arch Phys Med Rehab. 2007;88(5):673‐680.
111.
LeeMSPittlerMHShinBCErnstE. Tai chi for osteoporosis: a systematic review. Osteoporos Int. 2008;19:139‐146.
112.
LeeMSPittlerMHErnstE. Tai chi for rheumatoid arthritis: a systematic review. Rheumatology. 2007;46:1648‐1651.
113.
LeeMSPittlerMHErnstE. Tai chi for osteoarthritis: a systematic review. Clin Rheumatol. 2008;27:211‐218.
114.
LeeMSPittlerMHErnstE. Is Tai Chi an effective adjunct in cancer care? A systematic review of controlled clinical trials. Support Care Cancer. 2007;15:597‐601.
115.
TerasawaK. Evidence‐based reconstruction of kampo medicine: Part I—Is kampo CAM?Evid Based Complement Alternat Med. 2004;1:11‐16.
116.
TerasawaK. Evidence‐based reconstruction of kampo medicine: Part II—The concept of Sho. Evid Based Complement Alternat Med. 2004;1:119‐123.
117.
YuFTakahashiTMoriyaJ. Traditional Chinese medicine and Kampo: a review from the distant past for the future. J Int Med Res. 2006;34:231‐239.
118.
TerasawaK. Evidence‐based reconstruction of kampo medicine: Part III—How should kampo be evaluated?Evid Based Complement Alternat Med. 2004;1:219‐222.
119.
IkegamiFSuminoMFujiiYAkibaTSatohT. Pharmacology and toxicology of Bupleurum root‐containing Kampo medicines in clinical use. Hum Exp Toxicol. 2006;25:481‐494.
120.
IkegamiFFujiiYSatohT. Toxicological considerations of Kampo medicines in clinical use. Toxicology. 2004;198:221‐228.
