Alternative Medicine
Alternative Medicine: An Overview
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Persons with brain injury are influenced by traditional medicine from the moment they arrive in the emergency room. Based on strict scientific methods of evidence, traditional or western medicine is the gold standard to which most new medicines and procedures are compared. Years of research and millions of dollars often are spent to prove traditional medical therapies “safe and effective”. This is to provide a safeguard against the potential dangers of new, untested medications, therapies and procedures.
Alternative medical practices are those philosophies, therapies, and medications that are frequently based in other cultures. They have often not been studied or do not meet western levels of scientific proof. Complimentary medicine practices are traditional medical practices which are used for purposes other than what they were proven or intended for, or as compliments to other standard therapies.
Both alternative and complementary medicines freequently lack unbiased, controlled research studies that prove them effective. Research may not have been done because of insufficient research money, a small group of patients that would benefit, lack of people who know how to provide the therapy, or the fact that the intervention makes no scientific sense to western practitioners.
Many families investigate alternative therapies because traditional medicine is not producing the results they hope for. They may believe alternative practices have fewer side effects or more dramatic benefits. But just as unscrupulous “snake oil” salesman used to roam the countryside, today we find persuasive, profit-oriented practitioners roaming the internet. They produce official looking promotional pamphlets or websites, promising results that may not be achieved. Lack of medical knowledge, a feeling of desperation, and the hope that alternatives suggest, many families become vulnerable consumers.
In 1997, it was estimated that 42% of Americans were using alternative medicine and spending an estimated 27 billion dollars. Many traditional practitioners realized other cultures had important lessons to teach, but unbiased information was largely unavailable.
In 1999 the National Institute of Health (NIH) established the National Center for Complementary and Alternative Medicine in response to some of these concerns. Its' goals are to review the literature/ scientific evidence, to determine where to focus future research efforts, to study alternative treatments, and to provide the public with accurate information. Their website can be a valuable source of information regarding ongoing medical trials, new therapies, and general information.
One method used to help evaluate alternative medical interventions is called Evidence Based Medicine. This approach asks four questions about the data supporting each medicine practice, procedure, or therapy to help one decide if they are worth trying.
1. Validity (believability/objectivity) - Is the supporting evidence unbiased, performed by knowledgable researchers and published in a well respected journal? Ex : If the owner of a bee farm says bee stings will cure attention span, and publishes these claims on the internet, would they be highly valid?
2. Importance (significant difference/benefit) - Did the results of the treatment produce a benefit that make it worth the risks? Were the “statistics” truthful and significant? Ex: If the bee sting medicine was “studied” in only two patients, caused an allergic reactions in one, improved attention span for only 30 minutes, and most of that time the person was in pain from the bee sting, can it really be considered beneficial?
3. Applicability (to put into effect) – Is the treatment performed easily, available to most people, medically possible, and cost effective ? Ex: If the bee sting medicine costs $1000 a day, can be kept only in the freezer, can be obtained only from one bee farmer in Alaska, and has to be injected by another person, is it applicable?
4. Purpose (does it help or changed something that makes life better ) – Does it do what it should, and does it work in all populations? Ex: Just because the bee sting medicine improved attention in one female child without brain injury, will work in male adults with brain injury? Does a 30 minute improvement once a day mean insurance coverage should support this treatment?
If a therapy or medicine does not meet any of these criteria, then a useful question is: Are the time, money, emotional investment, and potential medical complications that could occur merited by the potential benefit of this treatment?
Some interventions are medically safe, but time intensive and expensive for the results they provide. Families may opt to pursue these if they have the time and money. Other families need to consider the effect on their future security, other family members, and their emotional feelings if the results are not what they hoped for.
Some examples of alternative therapies used by those with brain injury include:
Mind Body: massage, dance, hypnosis, prayer, aromatherapy, hippotherapy, aquatics
Biologically Based: herbal supplementation, vitamins, hyperbaric oxygen
Energy: Reiki, Qigong, magnetic fields, TES, electric stimulation therapy
Manipulative: chiropractice, craniosacral therapy, acupuncture, neuromuscular reeducation, rolfing, hellerwork, acupressure, feldendrais), conductive education
Resources
www.nccam.nih .gov/nccam/resources/cam
www.neuroskills.com
www.urmc.rochester.edu/medicine/res/cats
www.med.unc.edu/medicine/edursrc
www.cebm.jr2.ox.ac.uk
JAMA 1997:279(19) 1548-1554 Why Patients Use Alternative Medicine
JAMA 1998:280 (18) 1569-1575 Trends in Alternative Medicine in the US
Elizabeth Moberg-Wolff MD is Medical Director of in-patient and outpatient pediatric rehabilitation programs at the Children's Medical Center, Medical College of Georgia, in Augusta, GA. She is board certified in Physical Medicine and Rehabilitation and is an Assistant Professor in the departments of Neurosurgery, Pediatrics and Neurology.