CAM includes diverse health care systems, practices, and products that are usually not considered part of conventional medicine - that is, medicine as practiced by holders of MD (doctor of medicine) or DO (doctor of osteopathy) degrees and allied health professionals.

By definition, complementary medicine is used together with conventional medicine, and alternative medicine is practiced in place of conventional medicine. But the terms are becoming interchangeable, as the practices often overlap.

Hong Wu, MD, Assistant Professor of Physical Medicine and Rehabilitation at the Medical College of Wisconsin, says, "In acute situations like heart attack or bleeding, conventional therapy may be more effective. But for chronic conditions, such as recovery from an illness or surgery, or even palliative care, CAM might help."

"My patients are looking for all different ways to take care of their painful condition. We usually try the conventional route first, but if at a certain point, treatment options are exhausted, we will look at different approaches, and see what else can be offered to our patients. CAM is a good complement to conventional medicine. It can help patients readjust their own body systems, and balance the yin and yang, based on Chinese medicine."

Pain Control Options
Dr. Wu, a pain specialist, practices at the Medical College of Wisconsin Pain Management Clinic at Tosa Center, and at the Froedtert & Medical College of Wisconsin Rehabilitation Medicine Clinic-West and East.

If a patient has pain in addition to muscle weakness, stiffness, or lack of range of motion; Dr. Wu often tries to control the patient's pain first by any means necessary, including non-steroid anti-inflammatory drug (NSAIDs), narcotics, and nerve or joint injections. "Meanwhile," she says, "I will recommend physical therapy to address the patient's physical and functional deficits in order to improve their function."

Besides the oral medications and injections, Dr. Wu uses topical medications like capsaicin, which is a compound found in chili peppers, or lidocaine, a local anesthetic that works by stopping nerves from sending pain signals.

"Other options," she says, "include manual therapy, heat/cold modalities and acupuncture." Acupuncture is rapidly evolving as an effective therapeutic modality for pain control, and has been proven effective in relieving postoperative pain, dental pain, and other painful conditions with very few side effects. It can also alleviate anxiety, panic disorder, nausea, and insomnia.

"As a pain physician, my goal is to eliminate or minimize patients' pain, and meanwhile improve their function and/or activity level," she says. "I have no desire to just give pain pills or shots, or to put patients to 'sleep' with medication. I want them to have an enjoyable and productive life, able to be a mom, be a dad, be a teacher, whatever their role is."

In addition to pain control, says Dr. Wu, "We often bring together a psychologist, physician, nurse, physical and occupational therapist, or social worker to discuss what the best is for our patient. It's integrative and multidisciplinary."

Herbs and Movement Therapy
Many of the Complementary and Alternative Medicines used in China are based on the ancient theory of chi, the energy that flows through the body. "Based on the theory, an excess or deficit of chi in the body can cause illness," explains Dr. Wu. "If you sprain your ankle, chi is believed to be blocked, resulting in ankle pain. We need to unblock the chi and facilitate the flow in order to relieve the pain."

The use of medicinal herbs is becoming increasingly popular. "Herb medicine has been practiced for thousands of years in Eastern countries like China," says Dr. Wu. "More and more medications are being made from herbs, and now many of them are made in the form of tablets or capsules." They may not be FDA-approved, Dr. Wu notes, therefore, patients should be careful in choosing them for medical use.

For chronic conditions associated with disease, Dr. Wu sometimes recommends movement exercises such as tai chi or qi gong. Dr. Wu says that several months' practice of these movement therapies may improve patients' musculoskeletal functions, such as body posture, balance, and ambulation, decrease the risk of falls, and alleviate pain. "In Eastern countries like China, these are often used as either daily exercise or an adjunct to their conventional treatment."

Tai chi is very helpful for people with pain from arthritis and fibromyalgia. Dr. Wu points out, "Tai chi is a type of body-mind exercise. It is gentle, low-impact, easy to learn, and does not require special equipment or machines. It helps improve endurance and stability, and possibly relieves stress. "I recommend that patients receive their Tai Chi training by qualified masters or therapists. Training and experience are very important for CAM," says Dr. Wu.

Qi gong is another type of movement therapy. It is more challenging than tai chi, says Dr. Wu. "You have to understand the concepts, and it takes more practice, but it may be very effective for you when properly taught and trained." Again patients should receive Qi gong training by qualified masters or therapists, says Dr. Wu. Inappropriate exercise of Qi gong may cause physical harm or discomfort.

If you're thinking about using CAM, make sure you speak to your physician first for advice or referrals. If you are already using a CAM treatment, be sure to notify your physician at your next visit.

P. J. Early
HealthLink Contributing Writer

This article includes information from the National Institutes of Health, the National Center for Complementary and Alternative Medicine, and the US Food and Drug Administration.

For more information on this topic, see the HealthLink articles Acupuncture Can Be an Effective Option for Children and Medical College Practitioner Eases Pain with Acupuncture.