Conventional medicine or mainstream medicine, which is often called as allopathic medicine, is based on the Cartesian model of dualism that holds the view that the human body and the mind are two entities. On the contrary, complementary and alternative medicine (CAM) views the human body and the mind as a single entity. Many mainstream therapies were once considered complementary until they were proven clinically effective through research. Currently, many mainstream practitioners are adopting CAM therapies to provide integrated or holistic care. The National Institutes of Health and National Center for Complementary and Alternative Medicine (NIH/NCCAM) have divided CAM therapies into five categories, namely, mind-body, biologically based, energy-based, manipulative body-based and alternative medical therapies. Many of these CAM therapies have been found to be effective in relieving pain, alleviating stress, reducing anxiety, increasing tolerance, etc., without the help of pharmaceutical drugs, which could have long-term side effects. One common aspect of CAM therapies is that they rely on techniques that enable the body to heal itself.
Conventional medicine is a term used to describe tested medical therapies that have been proven to be safe through experiments. Allopathic treatment and certain cognitive treatments fall under conventional medicine where the disease is identified based on symptoms, confirmed using diagnostic tools and treated using prescription drugs. Conventional medicine could be used in combination with complementary medical therapies (such as meditation and massage) to provide a supplementary healing to the patient. On the other hand, alternative medical systems such as homeopathy, Traditional Chinese medicine and Ayurveda are parallel treatment systems that could be followed solely and independently instead of the mainstream medicine.
Allopathic medical practice
Allopathic or mainstream medical practice is based on the concept that the physical world is composed of tiny parts that run in coordination as a single machine. It is also based on the concept that the mind and body are separate entities, and need to be treated in different ways. This is called the Cartesian worldview of body-mind separation or the Newton-Rene Descartes paradigm of objectivity. The concept of mechanism was developed by Newton, and it was later adapted to the human body as Dualism by Descartes (Palmer & Bertalanffy, 2007).
Disease causation and diagnosis
In conventional medical practice, a disease is said to have occurred when there is presentation of symptoms. The symptoms would be signs that indicate malfunctioning of a body part that could be diagnosed using laboratory tests of body fluids and technological interventions (Barry & Beitel, 2008).
The treatment regime followed in allopathic medicine is unique, and is probably one of the distinctive features when compared to complementary and alternative medical practices. The medicines that are prescribed by the physicians are chemical compounds (pharmaceutical drugs) that intend to correct the malfunction in the body. In current scenario, allopathic treatments aim at efficacy and safety that are governed by regulatory bodies such as the US Food and Drug Administration (FDA).
Complementary and alternative medical therapies and practices
According to National Institutes of Health, National Center for Complementary and Alternative Medicine (NIH/NCCAM), all medical interventions or therapeutic procedures that are not part of mainstream medicine are categorized as complementary and alternative medicine (CAM). It is interesting to know that therapies that were once considered non-conventional are now part of allopathic medicine (such as hypnosis and cognitive behavioral therapy) (Barry & Beitel, 2008).
Types of CAM therapies
There are five types of CAM therapies described by the NIH/NCCAM. Mind-body therapies (MBTs) view the body and the mind as one, and therefore, aim to heal holistically using meditation, prayer, feedback, relaxation, hypnosis, breathing exercises, etc. Biologically based therapies use natural substances such as herbs, probiotics, nature –based diet, etc. Manipulative and body-based therapy includes chiropractic techniques, massage, reflexology and osteopathic medicine. Energy therapies are based on use energy field based therapies to redirect energy flow through the body to restore balance. Alternative medicine systems use drug systems that are analogous to allopathic medicine. Examples are homeopathy, traditional Chinese medicine, Ayurveda, Siddha, Unani, acupuncture, acupressure, etc., These systems utilize a very similar treatment path as the allopathic system where the physician analysis the symptoms, gives a diagnosis and prescribes a drug (Barry & Beitel, 2008).
Acupuncture is based on the philosophy of prevention rather than cure, where the underlying concept is maintaining yin and yang, the two opposite interdependent forces. Accordingly, a person who is healthy has a balanced energy, which is disturbed during an illness. The energy is thought to be brought to the surface of the skin from within the organs via meridians. These meridians meet on the surface of the skin to form the various acupuncture points.
Mechanism of treatment and healing
The traditional acupuncture concepts were not studied in correlation with anatomy. However, experimental data have now elucidated that the acupuncture points stimulate A-δ and C afferent fibers in the muscles that transmit pain signals to the spinal cord, and stimulating the various acupuncture points leads to release of pain inhibiting neuro-suppressors. Acupuncture requires a functioning sensory nervous system for the treatment to be effective. Using a combination of acupuncture points have been observed to provide better pain-management when compared to stimulating just a single point (Wang, Kain & White, 2008).
Traditional Chinese medicine (TCM)
TCM is often practiced in combination with acupuncture. Similar to acupuncture, TCM also aims at restoring the internal energy balance, and views the human body as a whole, unlike the allopathic system of dualism.
The texts pertaining to TCM describe the body as a composition of five Zang organs, six Fu organs, five tissues, five senses, four limbs and body fluids that are interconnected via meridians. Yang is dynamic, external, ascending, warm, bright, functional, warming and promotional in nature. Yin is static, internal, descending, cold, dim, material, substantial and nourishing in nature. An illness is thought to be caused when there is an excess or deficiency of Yin or Yang (Chan et al 2010).
Disease diagnosis and treatment
A disease is identified based on four methods of diagnosis, namely, the location, the cause, the nature of the disease and the relationship between the pathogenic factors and the disturbed Qi (internal energy). It is imperative for a TCM practitioner to correctly differentiate the syndromes for an effective treatment regime. Typically, the diagnosis is made by observing the tongue and the pulse at different locations in the body. The principle treatment would be to reduce the excess or increase the deficient. Therefore, a therapy regime could be to nourish Yin or Yang or reduce the amount of Yin or Yang. The drugs used in TCM are botanicals (Chan et al, 2010).
Aromatherapy is a complementary medicine system that uses delicate fragrances for calming and relaxing the mind and body.
Mechanism of healing and treatment
The mechanism of action of aromatherapy is still elusive, but is reckoned to stimulate the natural production of sedative and calming chemicals through olfactory sensors in the body upon application. The oils are added to steamers and inhaled or applied onto the skin and massaged. Aromatherapy has been used in medical contexts such as antibacterial treatment, as analgesics, anti-inflammatory, antitoxic, etc., where some of these properties have been backed-up by extensive research. More commonly, aromatherapy has been used for stress-reduction, and as a pain management tool during labor and as a post-operative care. An experiment conducted on elementary school teachers indicated that aromatherapy stimulates the autonomic nervous system, which is indicated by heart rate variability (HRV). The school teachers who displayed moderate to high stress showed high HRV when subjected to aromatherapy indicating the effectiveness of the therapy. The fragrances are obtained by distillation of herbs, flowers, roots and other botanicals. The resulting cold-pressed essential oils are volatile, and thus, require a carrier oil such as sesame, almond, grapeseed oil, Calendula, Arnica, Shea butter, etc. (Chang & Shen 2011).
Naturopathy practitioners, also called as NDs, base their treatment regime on the concept that the human body can heal itself if steered towards healing using organic food. Just like other CAM therapies, naturopathy does not differentiate the body and mind, but treats the person as a whole.
Disease causation, diagnosis and treatment
Typically, diagnosis is done through symptom analysis, medical history and physical examination. A balanced diet and proper nutrition are the basis of naturopathy medicine. Food is the prescribed drug that is used both for treatment and prevention of an illness through package diets that are tailored for various conditions such as hypoallergenic reactions, obesity, anti-inflammatory, etc. Sometimes supplements such as vitamins and minerals are also prescribed, if necessary, to balance the diet. Naturopathy physical medicine is another discipline of traditional naturopathy that employs body manipulative techniques in combination with massage, energy therapies and exercises for a holistic treatment approach (Fleming & Gutknecht, 2010).
Chiropractic therapy was popularized by Daniel David Palmer in 1895, which deals with diagnosis and treatment of neuromusculoskeletal problems with emphasis on subluxation. It is a manipulative and body-based therapy that includes concepts from traditional bone-setting and osteopathy (Murphy et al, 2008).
Diagnosis and treatment regime
Even though the concept of chiropractic therapy is nearly 120 years old, the diagnostic aid used are quite modern. Skeletal imaging, laboratory tests, physical examinations and orthopedic assessments are some of the modern techniques used by chiropractors to assess a problem. Manual manipulative techniques such as spinal manipulation, joint manipulation, applied kinesiology chiropractic technique, transcutaneous electrical nerve stimulation (TENS), manual muscle testing and rehabilitative exercises are used as part of the treatment regime. Even though chiropractic therapy is very safe and effective, it requires skill and knowledge to attain the desired results (Murphy et al, 2008).
Massage therapy can be defined as the systematic manipulation of the soft tissues of the body to elicit a therapeutic response. Massage therapy is one of the widely practices form of touch therapies, which is often used in combination with aromatherapy, body manipulative therapies and energy therapies. Rolfing, friction massage, lymph drainage, shiatsu and Swedish massage are the various types of massage therapies currently in practice around the world. The mechanism of healing is thought to be brought on by the release of natural painkillers from the muscles, promotion of blood circulation and increase in waste removal (Tsao, 2007).
Treatment regime involves use of different types of massage strokes to elicit different therapeutic response. Vibration, pounding, rubbing, kneading and gliding are the five popular strokes used in Swedish massage. Research has proven that massage therapy is beneficial for stress-relief, alleviation of pain when imparted via multiple sittings (Barry & Beitel, 2008).
Yoga originated in India thousands of years ago. It consists of a series of postures that are performed slowly and sequentially with deep breaths. The postures involve the manipulation of one’s body to form the postures. Yoga, when done correctly, has been found effective in pain-relief, controlling blood pressure, asthma, stress-relief, elevating mood, regularizing the menstrual cycle, regularizing the sleep pattern, reduce anxiety, alleviate pain related to pregnancy, etc. Though yoga is a popular exercise technique often followed for weight loss and general health maintenance, it can be extended to the above-mentioned chronic conditions with good results (Field, 2011).
There are multiple yoga postures that could be recommended for a single ailment. For example, a lower back pain could be alleviated through repetition of the bow pose, in combination with the cobra pose. The process of attaining the pose is just as important as holding the pose.
Meditation involves taking slow and deep breath that is known to lower blood pressure, anxiety and increase concentration. Mindful meditation utilizes the same framework of traditional meditation, but focuses on conscious yet detached observation of emotions and feelings as one thinks about various experiences from past and present. The core concept of meditation is to accept and acknowledge the distractions that arise when a person is trying to focus on an object. However, the concept extends to the fact that the person should learn to calmly disengage oneself from the distraction after accepting its presence (Zeidan et al, 2012).
The patients who undergo mindful meditation are taught to control their minds via attention regulation, body-awareness, emotion regulation and changing the view regarding one’s own body. Mindful meditation has been found to be effective in patients with chronic pain whose pain threshold improved greatly once they learned to accept and acknowledge the pain (Hölzel et al, 2011).
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