Complementary and alternative medicine - Spontaneous recovery from disease

Alternative and complementary medicine refers to products and practices which are not part of the standard medical procedure that you get when you go to a hospital. Though the terms are often used interchangeably, alternative refers to when a practice aspires to replace standard medical care whereas complementary practices only aspire to complement standard medical procedure. For sure, for sure, medical research is far from a complete understanding of the physiology and anatomy of humans, and there are almost certainly many effective remedies which are not a part of the standard repertoire today. In the future we will no doubt see many advances in science and in consequence, new therapies to treat disease.

Having said this, complementary and alternative medicine suffers from what I consider to be a much more serious problem. First of, many of the techniques and practices used in alternative and complementary medicine have never been tested, or have not gained any support, in controlled studies and hence they have never proved to have any "real effect" (as opposed to placebo effect which they probably do have). Even more serious, because alternative therapies have often not been tested properly, it is hard to tell whether they have any serious side effects. What is almost certain is that if a particular substance has any effect at all, then it is more than likely to have side effects as well (see table at bottom of this article).

Sometimes alternative practices turn out to be effective and when they do they are eventually assimilated into standard medical practices. To be fair, this assimilation process can sometimes be agonizingly slow and some doctors are probably too conservative, however, the essence of the matter is that when an alternative treatment or therapy has gained enough support in studies it will cease to be "alternative" and become "standard". This is to some extent true for acupuncture, which is now used occasionally as a treatment for various conditions even though it has long been controversial. However, importantly, the mechanism that makes acupuncture work seems to be different from what has been claimed by those who have used this procedure in the past. No meridians have ever been demonstrated. Instead it seems that acupuncture stimulate pain sensing nerve endings. These nerve endings in turn exercise a form of lateral inhibition meaning that they block other pain sensing nerve endings around them, thus preventing the patient from experiencing pain in that area.

Complementary and alternative practices can often give the illusion of being effective because we recover spontaneously from diseases. We have an impressive immune system, which deals with seemingly limitless pathogens in an extremely efficient and competent manner. I am making up the numbers here, but say that after taking a certain herb 90% of all people recover from the flue within a week. Wow, surely there must be something to it then? But wait a minute. Almost everyone (say 90%) recovers from the flue within a week if they just stay home in bed. Suddenly these herbs do not seem that fantastic, and they seem even less attractive if you take into account the often excessive price tags.

Back pain is another example that deserves mention, and these figures I am not making up (they come from a lecture I attended recently). Nine out of ten (90% that is) cases of acute back pain will go away after one week. Combine this with the fact that 60-80% of all individuals will experience back pain sometime in their lifetime and what you get is an awful lot of cases of back pain that goes away in one week. Not surprisingly, at least not to a cynic like me, there are a huge number of alternative or complementary therapies for back pain, and they all seem really successful as long as you do not compare them to no treatment at all…

Here is my advice, my alternative therapy if you like. If you experience back pain, and don't have any other serious symptoms such as your vertebrae penetrating your back muscles (in which case I would advice going to a doctor), don't spend your money on all sorts of alternative/complementary therapies, rather relax for one week and see if the pain simple goes away (in most cases it will). Once you have recovered, use the money you would have spent on a therapy on something nice, such taking your girlfriend to a cozy restaurant. If the pain does not go away after one week, go see a doctor and have your back checked up…

Writing about alternative medicines is something that really warms my heart. I have written about homeopathy here, here and here, and here I have written about the role of the placebo effect.