Introduction
People still often utilize complementary and alternative medicine (CAM), apart from conventional medicine. For example, a 2012 national survey showed that over 30% of adult Americans and 12% of children used CAM approaches to treatment (National Center for Complementary and Integrative Health [NCCIH], 2021). This paper will review the differences between CAM and conventional medicine in terms of regulation and philosophy and discuss the use of one CAM approach to managing low back pain.
Comparison of Regulations and Oversight
CAM and conventional medicine have different degrees of regulation and oversight in the US. Conventional medicine is highly regulated and should comply with a standardized system of governmental regulations. In other words, all healthcare professionals employed in this type of healthcare should complete the same training and receive certifications, and conventional drugs should comply with regulations regarding drug development, approval, production, and marketing.
In contrast, CAM is not as strictly regulated as conventional medicine. For example, CAM products are usually classified as dietary supplements, which is why they are not subject to thorough control in terms of efficacy, safety, and marketing claims (Li et al., 2018). As for CAM practitioners, there is no standardized system of training and certification for these professionals in the US (Li et al., 2018). As a result, there are variations in how different states regulate and oversee CAM.
Differences in the Terms and the Role of Conventional Medicine
Within CAM, three different terms are used to describe treatment approaches: complementary, alternative, and integrative. The difference in the terms is explained by the varying role of conventional medicine in relation to CAM. In particular, complementary medicine describes a situation in which non-mainstream treatment approaches are used in combination with conventional medicine (NCCIH, 2021). In contrast, alternative medicine means the use of non-mainstream methods instead of conventional medicine (NCCIH, 2021). Hence, while the role of conventional medicine is important in complementary approaches, it is insignificant in alternative treatment methods.
Integrative medicine bears a similarity to complementary approaches but in a more coordinated way. It focuses on healing the person as a whole and combines conventional methods, such as medications and psychotherapy, with complementary ones, for example, yoga and acupuncture (NCCIH, 2021). The role of conventional care in integrative medicine is, perhaps, even more significant than in complementary medicine because it is closely interwoven with CAM. By using integrative medicine, healthcare professionals seek to find the most effective combinations of conventional and non-mainstream methods to bring the greatest benefits to the individual’s well-being.
The Philosophy of CAM
The philosophy of CAM is focused on healing the whole person. As such, it pays attention not only to the patient’s body but also to the mind, spirit, and community (Rakel & Weil, 2022). In contrast, conventional Western medicine is focused on the patient’s disease, which is determined on the basis of pathology (Sugito & Son, 2019). The fact that CAM takes a holistic view of the individual’s well-being is what often attracts people to non-mainstream practices (Li et al., 2018). For example, CAM usually takes into consideration such aspects as diet, spirituality, and physical activity, which are important components of health.
Another difference between the philosophy of CAM and conventional medicine is related to the evidence base and standardization. Conventional medicine is evidence-based, meaning that clinicians integrate their clinical experience with the best available research information. For this reason, conventional Western medicine uses known and standardized mechanisms to identify diagnoses and treat diseases (Sugito & Son, 2019). In contrast, CAM is usually based on the experience and opinion of the practitioner, which is why its procedures are not standardized and not underpinned by scientific evidence (Sugito & Son, 2019). This is the reason why many US healthcare professionals avoid using CAM approaches in their practice.
Chiropractic for Low Back Pain
The selected alternative medicine practice is chiropractic, which involves the diagnosis, treatment, and prevention of musculoskeletal disorders. The chosen medical condition is low back pain, which is the most common pain condition for using CAM (Rakel & Weil, 2022). According to a 2012 survey, 8.4% of adults used chiropractic or osteopathic manipulation, and 8.9% of US adults employed CAM approaches for back or neck pain (Rakel & Weil, 2022). Individuals’ use of CAM methods for low back pain seems justifiable since the evidence shows that chiropractic can indeed help individuals with this condition.
For example, one randomized controlled trial compared the outcomes of chiropractic care to the health condition of the control group with no intervention. In this study, those patients who received chiropractic care for four weeks experienced a decrease in low back pain and disability resulting from this condition (Vining et al., 2020). Moreover, the participants from the experimental group demonstrated increased strength and endurance after the intervention compared to the control group (Vining et al., 2020).
Another study compared the effectiveness of integrative care and chiropractic for low back pain. Researchers found that integrative care was only slightly more effective than chiropractic alone but, at the same time, significantly more resource-intensive (Bronfort et al., 2020). These findings suggest that chiropractic can be used as an alternative approach to managing low back pain since it is effective on its own. However, it can also be used as part of integrative medicine and bring more health benefits.
Conclusion
Although CAM has been criticized for being non-standardized and not evidence-based, it is still used by many people. CAM attracts individuals due to its affordability and holistic approach to health. Chiropractic is one CAM practice that can be used for managing low back pain. Such chiropractic interventions as manual spinal manipulations or soft tissue massage can be used as an alternative treatment, or they can be included in integrative care.
References
Bronfort, G., Maiers, M., Schulz, C., Leininger, B., Westrom, K., Angstman, G., & Evans, R. (2022). Multidisciplinary integrative care versus chiropractic care for low back pain: A randomized clinical trial. Chiropractic & Manual Therapies, 30(1), 1-17. Web.
Li, B., Forbes, T. L., & Byrne, J. (2018). Integrative medicine or infiltrative pseudoscience? The Surgeon, 16(5), 271-277. Web.
National Center for Complementary and Integrative Health. (2021). Complementary, alternative, or integrative health: What’s in a name? Web.
Rakel, D. P., & Weil, A. (2022). Philosophy of integrative medicine. In D. Rakel & V. Minichiello (Eds.), Integrative Medicine (5th ed., pp. 1-9). Elsevier Health Sciences.
Sugito, R., & Son, D. (2019). Obstacles to the use of complementary and alternative medicine by primary care physicians: Preliminary study. Traditional & Kampo Medicine, 6(3), 173-177. Web.
Vining, R., Long, C. R., Minkalis, A., Gudavalli, M. R., Xia, T., Walter, J., Coulter, I., & Goertz, C. M. (2020). Effects of chiropractic care on strength, balance, and endurance in active-duty US military personnel with low back pain: A randomized controlled trial. The Journal of Alternative and Complementary Medicine, 26(7), 592-601. Web.