Beyond your GP, what's the alternative?

Friday 10th June, 2016

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Complementary and alternative medicine covers a broad spectrum of treatments, including acupuncture, acupressure and the ancient practice of shiatsu. However the NHS has begun to remove some of its CAM therapies from recent treatment guidelines.

TheCAM treatments focus on relaxation and stress relief, as well as sore muscles. Many GPs and hospitals provide access to complementary practices.

Image: Flickr, Richard Craig

The NHS’s position on CAM therapies is set out by the National Institute for Health and Care Excellence (NICE), which looks at trial results, and the effectiveness of treatments. NICE has recently begun to remove CAM therapies from the treatment guidelines for certain problems, such as lower back pain and sciatica (any sort of pain caused by irritation or compression of the sciatic nerve), and palliative care in treatments for adults.

Edzard Ernst, professor of Complementary Medicine at the University of Exeter's Peninsula Medical School, raised some concerns about the NICE assessment: “Many [of the programme’s] guidelines have evaluated CAM, but there is a substantial degree of inconsistency. The decision of whether or not to consider CAM for any given topic appears to be somewhat arbitrary.”

According to a survey by the Department of Health, more than two thirds of doctors believe alternative therapies should be freely available on the NHS.

The EU Community Research and Development Information Service (CORDIS) estimates that consumers are now spending about £780 million on CAM, and that there are around 150,000 registered medical doctors with some CAM certification.

However, CAM practitioners are not currently regulated by any professional body, making it difficult to identify the best person for specific needs.

Phil Ranson, NICE employee, said: “Though there is very little evidence about the efficacy of many CAM treatments, the use of CAM is widespread and increasing across the developed world. There is a clear need for more effective guidance for health professionals, and for the public.”

However, David Colquhoun, pharmacologist at University College London (UCL), refers to CAM therapies as “voodoo medicine”, and discourages the use of such therapies within the NHS system.

Image: Marta Del Buono

Regarding the studies of CAM effects, Tredinnick said: “Some evidence is very good; some is not so good—but there is a lot of evidence that patients are content with these services. Where patients are gaining benefits, those services should be available.”

Mark Barwell, a shiatsu and reiki teacher, said: “CAM therapies encourage good eating habits, appropriate physical exercises and a positive mind-set. By maintaining a healthy lifestyle, it is possible to not only sustain a sense of wellbeing, but also to help to ease the strain on healthcare services by not needing them as much.”

By working together, CAM and mainstream medicine can provide a greater range of personalised support for each patient. However, some complementary medicines can interfere with mainstream treatments.

For instance, although turmeric is well known for its cancer-preventing properties, patients must stop ingesting the spice if they are actually diagnosed with cancer, because it interferes with chemotherapy.

Juliet Bouverie, on cancer charity Macmillan’s website, writes: “Often patients do not report their use of complementary therapies to health care professionals.” This can affect the results of the healing process.

Image: Marta Del Buono

But as Barwell pointed out: “Mainstream medicine has its place, and so do other forms of healthcare treatment. Reiki, for example, may not be able to grow back an amputated limb or repair a damaged heart valve, but it can support the person's self-healing abilities.”

To find out more about CAM therapies, the Royal London Hospital for Integrated Medicine (Europe’s largest integrated medicine centre) has a specialised library open to the public for free consultation, and provides a wide range of complementary therapies.