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Complementary therapies


Expert reviewer, Dr Luke James, Medical Director, Bupa Health Clinics
Next review due June 2020

The use of complementary therapies (often alongside conventional medicine) is popular in the UK. But are complementary therapies really effective? And why are they so popular? Here we discuss. But to begin with, it’s important to understand the difference between complementary therapies and conventional medicine.

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What is conventional medicine?

When you use regulated healthcare services in the UK – for example your local GP surgery, health centre or hospital – the vast majority of the time you’re diagnosed and treated according to the principles of what we might call conventional medicine. For a treatment to be offered, there needs to be evidence that it’s beneficial for the problem being treated, and that these benefits outweigh any risks.

For a medicine, this means it has been through extensive clinical trials. In these trials, the conditions are controlled very carefully and the medicine has to consistently show that it works on multiple occasions. For surgical procedures, outcomes are measured over time to inform when surgery should be used to try and treat a problem.

An organisation called the National Institute for Health and Care Excellence (NICE) reviews treatments for conditions and issues guidelines for medical professionals on their use. It looks closely at all the evidence around how effective a treatment is. It also considers how cost-effective it is. For some of the therapies described here, we’ve outlined NICE’s position.


What are complementary therapies?

Complementary therapies are methods of trying to treat illnesses, and these methods fall outside of conventional medicine.

The word ‘complementary’ refers to the fact that they may be used in addition to the conventional medicine approaches advised by medical professionals.

Some practitioners use these therapies on their own, instead of conventional medicine. This use makes it an alternative therapy rather than a complementary therapy. Remember: these therapies should never replace treatments prescribed by a medically qualified professional. We advise not using them as alternative therapies. It’s important to let your doctor know about any problems you’re having before seeking treatment with unconventional therapies.

Some complementary therapies, such as acupuncture and reflexology, are based on older or traditional forms of medicine. Others, such as osteopathy and chiropractic, are more recent developments. Things like herbal medicine can be seen as a very rough precursor to modern medicine; there are many medicines that have been discovered through understanding the effects of natural substances. Herbal medicines can be seen as ‘unrefined’ medications, with varying doses and sometimes with other ingredients in them.


Why are complementary therapies so popular?

Research carried out by YouGov in 2015 showed the popularity of complementary and alternative therapies in the UK. Half of respondents said they thought herbal medicine is effective for treating illness. Around four in 10 said they thought homeopathy could be effective. Many people anecdotally refer to a time when a complementary therapy has helped them –you might know someone who swears by a particular treatment.

There are good reasons why complementary treatments (some of which have no clinical evidence to support them), might appear to have been helpful for an individual. One of these is the ‘placebo effect’.

The placebo effect refers to the fact that when someone expects their symptoms to improve, they do improve. So, when someone undergoes a treatment that they think will have a certain benefit, they may experience this benefit, but not because the therapy has actually been clinically effective. This is something that’s been observed in medicine for hundreds of years, and is proven to exist through experiments. But the reasons for it aren’t well understood.

How can I access complementary therapies?

Most complementary therapies can be accessed privately through clinics, practitioners and stores. In some scenarios, your doctor may refer you for complementary therapy funded by the NHS, but this is very rare.

When choosing a practitioner for a complementary therapy, it’s important to do so carefully. The more widely practised therapies have governing or regulatory bodies. These bodies might be a good place to start to understand how practitioners in the field are regulated and registered, and where to find trusted practitioners. Where relevant, we have included some of these in the sections below.

You may also find the Complementary & Natural Healthcare Council (CNHC) useful. They are a voluntary regulator for practitioners of complementary therapies. Visit the CNHC site for more information.

Aromatherapy

Aromatherapy is a therapy that uses fragrant oils extracted from plants. They can be inhaled, used as massage oils, applied as a cream, or added to a warm bath. Some aromatherapy products are available for use at home, or you might see an aromatherapist for an appointment.

Aromatherapy is generally used for relaxation, but there are also claims that it can help to ease specific symptoms or illnesses. In particular, people may try and use it for:

  • long-lasting pain
  • stress, anxiety and depression
  • indigestion
  • cognitive disorders
  • burns and blisters
  • skin infections

There’s no evidence to show that aromatherapy can cure or prevent any type of illness. Some studies have suggested that it may promote relaxation and help to relieve anxiety for some people, but more research is needed to be sure. NICE recommends that it should be tried for people with dementia who are experiencing agitation, if other approaches aren’t working. It may also be used for someone with cancer, particularly at the end of their life, to try and improve quality of life.

Some aromatherapy preparations can cause side-effects for certain people, including some that are very serious. If you have an illness, it’s important that you consult with your doctor before trying aromatherapy. And remember that it should not be used in place of any conventional treatment you’ve been prescribed. If you’re using aromatherapy products at home, make sure you follow the instructions carefully.

Find out more about aromatherapy.

Acupuncture

Acupuncture is an ancient traditional Chinese medicine that uses needles inserted into specific points in the body. The original idea was to restore balance to different ‘energies’ in the body. It’s still widely used, and is one of the most well-known and popular complementary therapies. Around 13 in 20 respondents to the YouGov poll said they think it’s effective.

It may be used for general relaxation and wellbeing. Practitioners also claim acupuncture is useful for a wide range of problems. Illnesses that people try to treat with acupuncture include:

  • aches and pain (especially back, knee, neck, jaw pain)
  • headaches and migraine
  • sickness after surgery or during chemotherapy
  • substance addiction
  • carpal tunnel syndrome
  • asthma
  • stroke
  • arthritis
  • bowel or bladder problems

There’s very little high-quality evidence for acupuncture being clinically effective, and it’s an area of ongoing debate. Some studies have shown promising results, but more research is needed. Areas where there may be some benefit include:

  • Headaches – It may be effective for treating and preventing headaches and migraine. NICE recommends acupuncture in this context.
  • Sickness associated with surgery or chemotherapy – It may produce results similar to anti-sickness medicines.

Acupuncture is quite safe and tends not to produce side-effects. However, it must be done by a properly trained practitioner. It’s not completely risk-free, and it’s not suitable for everyone, so make sure you speak to your doctor before deciding to have acupuncture.

The self-regulatory organisation for acupuncture in the UK is the British Acupuncture Council.

Find out more about acupuncture.

St John’s wort

St John’s wort is a herbal remedy extracted from a wild plant. It has been used for hundreds of years to try to treat depression. You can buy it without a prescription. Studies have shown that in some circumstances it can be beneficial for adults with mild to moderate depression. However, NICE doesn’t recommend prescribing it, and your doctor won’t advise that you use it. This is because the products available vary in how strong they are, so it’s not possible to know what a safe dosage is. St John’s wort can also cause serious problems if it’s taken alongside conventional medicines. Sometimes active ingredients in the St John’s wort preparation can react with the conventional medicine, causing adverse effects. It can also make hormonal contraceptives not work. These reactions and adverse effects aren’t well understood, so it’s safer to avoid St John’s wort altogether.

Homeopathy

Homeopathy is a medical system based on the theory that ‘like cures like’. The idea is that a substance that usually causes certain symptoms, when given in very small doses, can cure the same symptoms. So homeopathic medicines contain a tiny amount of an active ingredient, heavily diluted. Practitioners claim it can be used to treat a wide range of conditions, including:

  • eczema
  • depression and anxiety
  • menopausal symptoms
  • allergies
  • bowel problems including Crohn’s disease and irritable bowel syndrome (IBS)
  • arthritis
  • asthma
  • migraine and headaches

There is no modern scientific basis for the theory behind homeopathy and there is no reliable evidence that homeopathy is effective in treating any condition. NICE does not recommend homeopathy at all, though it can (very rarely) be accessed through the NHS.

The placebo effect (see ‘Why are complementary therapies so popular?’ above) may explain why homeopathy is still quite popular.

Massage therapy

Massage is a therapy where a practitioner manipulates the soft tissues of the body, usually with their hands. It’s mainly used for relaxation and general wellbeing, but also to manage pain. It’s a very broad term covering lots of different types of practice, so it’s hard to make general statements about how effective it is. It has been shown to have some benefit for:

  • sore muscles
  • back pain
  • fibromyalgia

It may also be used to promote general wellbeing for people with long-term conditions like cancer or dementia.

Osteopathy and chiropractic

These are manual therapies, where practitioners use their hands to work with joints, muscles and tissues. They’re generally used to try and treat conditions relating to the muscles, bones and joints, but people may try them for other conditions.

Manual therapy, in general, is known to be effective for some conditions:

  • low back pain (but only when used alongside exercise)
  • osteoarthritis (but only when used alongside exercise)
  • long-term neck pain with an unclear cause

But this doesn’t necessarily mean that osteopathy or chiropractic will be a good option for you. If you have problems with your muscles, bones or joints, it’s important you discuss your symptoms with your GP first to see whether it might be appropriate.

Find out more about osteopathy.

The regulatory body for osteopathy in the UK is the General Osteopathic Council.

The statutory body for chiropractors in the UK is the General Chiropractic Council.

Reflexology

Reflexology is another manual therapy. It works on the belief that specific areas of the foot correspond to different parts of the body. Stimulating these areas of the foot is supposed to be able to treat the corresponding areas. This idea has no basis in science and there is no evidence for the clinical effectiveness of reflexology. 


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Related information

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  • Reviewed by Nick Ridgman, Head of Health Content, June 2017
    Expert reviewer, Dr Luke James, Medical Director, Bupa Health Clinics
    Next review due June 2020



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