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Complementary therapies

Expert reviewer, Dr Adrian Raby, General Practitioner
Next review due February 2025

Complementary therapies are treatments which do not lie within mainstream medical care. They include, such things as acupuncture, chiropractic, osteopathy, homeopathy and herbal medicines. Many people in the UK choose to use therapies like these alongside their standard medical treatment.

woman receiving massage by a therapist

About complementary therapies

Complementary therapies offer a different approach to conventional or mainstream medicine.

Conventional medicine is based on research evidence, where possible. Its treatments and medicines have been tested to see whether and how well they work. This is called evidence-based medicine. Your doctor offers you care based on the best evidence and their clinical judgement. This is the approach that doctors take when you use regulated healthcare services in the UK. These include your local GP surgery, health centre or hospital.

Research about complementary therapies is mixed and less certain. Some therapies have been tested and found to work. Others have been tested and found not to work. Often there’s no clear evidence to show whether they work or not. Some therapies haven’t been properly tested at all.

In the UK, there’s an organisation called the National Institute for Health and Care Excellence (NICE). It produces guidance and advice on evidence-based care for healthcare professionals. This covers a wide range of medical conditions. NICE guidance includes information on which treatments are likely to work. For some of the therapies described here, we’ve outlined NICE’s position.

There is a wide range of different complementary therapies available. Some are more widely used and mainstream than others. Below we give a very brief outline of some of the main ones. If you choose to have a complementary therapy, your therapist can explain exactly what it will involve.

Complementary or alternative?

Complementary therapies are used alongside, or as well as, conventional medical care. But you might hear the term ‘alternative therapies’ used as well. This is when these therapies are used instead of, rather than alongside, your medical treatment. If you’re thinking about using alternative therapies, it’s important to talk to your doctor before you make any decisions. They can explain the possible risks.

Why are complementary therapies so popular?

Complementary therapies are very popular. In the UK, around nine out of 10 of us have tried a complementary or alternative therapy at some point. There are many reasons why people choose to use them.

  • Conventional treatments may not be working as well as you would like, or haven’t suited you.
  • Complementary therapies can feel like a more ‘natural’ approach. (But remember that natural doesn’t always mean harmless).
  • You may get comfort from the therapist through their touch and their supportive attention, and the time they can spend with you.
  • Complementary therapies may take a more holistic approach – treating the whole person.
  • They may help you feel better. Many complementary therapies focus on relaxation and reducing your stress.
  • Choosing a complementary therapy may help you feel you’re more in control. You’re playing an active part in your medical treatment.

Finding a complementary therapist

If you think you may have a new medical problem, or you have an existing medical condition, contact your GP for advice first.

In most cases, complementary therapies are not available on the NHS. This means you’ll probably have to pay for them. It’s possible that your GP or other health professional may be able to recommend someone. Some health professionals are trained as complementary therapists. And some GP practices offer complementary therapies as part of their care.

Is my therapist qualified?

For most conventional medical treatments, you may have your healthcare professional who has to be registered with a professional body. This shows that they have reached a certain standard and are qualified to give you that treatment.

Among complementary therapists, the only ones that legally must be registered are osteopaths and chiropractors. Other complementary therapists can choose to become registered with their professional body. They may do this to show that they are qualified, and have met a national standard of practice. So, it’s a good idea to choose a complementary therapist who is registered with a professional body.

You may find the Complementary and Natural Healthcare Council (CNHC) useful. It’s a voluntary regulator for complementary therapists, set up by the UK Government.

Questions to ask your therapist

Here are some questions you can ask your therapist to help you decide whether they are right for you.

  • How many years of training do they have, and how long have they been practising?
  • What training and experience do they have in helping people with your condition?
  • Is there scientific research into using this therapy with your condition?
  • What benefits can you expect?
  • Are there any side-effects of the therapy?
  • How long is the course of treatment, and what will it cost?
  • Are they properly insured, and what would happen if you have an injury while with them?

Acupuncture

Acupuncture is a traditional Chinese treatment. Your therapist puts thin needles into specific points on your body. This affects your nerve impulses. It’s one of the most widely used and better researched complementary therapies. Acupuncture is mainly used for managing pain.

NICE says that there’s enough evidence to recommend acupuncture as an option for the following conditions.

  • Long-term (chronic) pain
  • Chronic tension-type headaches
  • Migraines

Although the evidence is less clear, acupuncture is often used for other conditions. These include those affecting the bones and muscles, pain conditions and feeling sick after an operation. If you’re considering acupuncture, you can ask your doctor or therapist to explain if it’s been shown to work for your medical condition.

Acupuncture is usually safe. It’s unlikely to give you side-effects if it’s given by someone who is properly qualified. However, it’s not suitable for everyone. So, talk to your doctor before deciding to have acupuncture.

Aromatherapy

Aromatherapy is the use of essential oils which come from plants, such as trees, flowers and herbs. You can breathe in the scent from the oils, which can be used as part of a massage or added to skin creams or a bath. You can buy aromatherapy products to use at home, or you can see an aromatherapist for an appointment. In hospitals that offer complementary therapies, aromatherapy is popular.

Aromatherapy is generally used for relaxation, but people also use it for:

  • easing long-lasting pain
  • relieving stress, anxiety and depression
  • improving sleep
  • cognitive (thinking and understanding) disorders

There’s no clear evidence that aromatherapy can cure or prevent any condition. Some research says it can help with mood, anxiety, sleep, nausea and pain. Other studies haven’t shown this. NICE recommends aromatherapy as one of the things that may help to improve wellbeing for people with dementia. But there’s no definite proof yet that it helps.

Some aromatherapy oils can cause side-effects. And some might possibly interact with some conventional medicines. If you’re pregnant, taking other medicines or have other health conditions you should always talk to your doctor before starting to use aromatherapy.

Homeopathy

Homeopathy is a medical system based on the theory that ‘like cures like’. The idea is that a substance that causes symptoms similar to a medical condition can help treat that condition when it’s given in tiny amounts. The lower the dose, the greater its effect is said to be. The ingredients for homeopathic medicines come from plants, minerals and animals. You can take them as tablets to swallow or put under your tongue, and in creams and ointments.

There is no clear evidence that homeopathy works for treating any condition or symptom. For this reason, homeopathy is not generally available on the NHS.

Some doctors and other health professionals are also trained homeopaths. The Faculty of Homeopathy regulates their training and work. There are other professional bodies for homeopaths who are not doctors.

Homeopathic medicines should use tiny amounts of active ingredient, so side-effects are unlikely. But some homeopathic medicines may contain other substances, or larger amounts of ingredients. Speak to your doctor if you’re thinking about trying homeopathy, to check on the medicine you plan to take. They can tell you if it’s likely to be safe for you.

Massage therapy

Massage therapy is where a therapist presses, rubs and manipulates your body’s soft tissues. Therapists usually use their hands and fingers. But you can also have a massage using arms, elbows and feet. Massage is mainly used for relaxation and general wellbeing. Some people also use it to manage aches and pains, especially in the bones and muscles.

There are several different types of massage. These include:

  • Swedish massage – this is the most common type, massage of the whole body
  • deep tissue massage – for long-standing problems with deep muscles
  • sports massage – before and after sports
  • aromatherapy massage – using essential oils
  • Schiatsu – using acupressure and stretching

It’s widely accepted that massage can help with a wide variety of musculoskeletal (bone and muscle) problems. NICE recommends massage, alongside exercise and psychological support, to treat low back pain. There’s some evidence that massage might be helpful for fibromyalgia, and improving quality of life for people with cancer or HIV/AIDS.

Osteopathy and chiropractic

Osteopathy and chiropractic are sometimes called manipulation therapies. These are where therapists use their hands to work on your joints, muscles and tissues. They’re often used to treat lower back, neck and shoulder pain. But they may also be used to manage sports injuries and headaches.

NICE recommends therapies like these to treat low back pain, together with exercise and psychological support.

Osteopathy and chiropractic are generally thought to be safe when carried out by a trained professional. One of the therapies used by chiropractors and osteopaths is spinal manipulation. It’s possible to have serious side-effects from this kind of treatment, but it’s very rare. Spinal manipulation isn’t suitable for everyone. So, always tell your doctor if you’re thinking about this type of therapy. And tell your therapist if you’re taking any medicines or have other health problems.

Osteopaths and chiropractors must be registered. The regulatory body for osteopathy in the UK is the General Osteopathic Council. For chiropractors, it is the General Chiropractic Council.

Reflexology

Reflexology is a type of foot (or hand) massage. The idea behind it is that there are zones running through your body that are linked to parts of your feet or hands. By pressing and massaging parts of your hands or feet, a therapist is said to improve energy flow to other parts of your body.

There is very little evidence to show that reflexology can treat any condition or relieve symptoms. But you may find it relaxing and soothing.

Herbal medicines

Herbal medicines come from plants and have been used for many centuries. Many conventional medicines began as herbal medicines. These were then refined into the modern treatments that are widely used by doctors. The idea of herbal medicines is to use plant ingredients in their original form. They may contain a complex mixture of chemicals present in the plant, rather than just one active ingredient.

Herbal medicines can be bought commercially. Or you may decide to visit a qualified herbalist. They will advise on which herbal medicines they believe would be best for you.

Possible risks with herbal medicines include the following.

  • Many have not been tested to see if they work.
  • Some herbal medicines can interfere with other medicines you take.
  • Different batches may vary in how much active ingredient they contain.
  • It’s not always known what the right dose should be.

To help reduce some risks, herbal medicines sold in the UK should now be registered with The Medicines and Healthcare products Regulatory Agency (MHRA). They are registered as ‘traditional herbal medicines’ and you may see the THR mark on the packaging. This shows that they meet standards of safety and quality. It does not mean, however, that they have been scientifically proven to work.

Always read the patient information leaflet that comes with your herbal medicine carefully. Herbal medicines are not right for everyone. Remember that, just because something is marketed as ‘natural’ or ‘herbal’ doesn’t mean it’s always safe to use. Herbal medicines contain ingredients that can have serious effects on your body, just as conventional medicines do.

If you’re considering taking a herbal medicine, your doctor can advise whether this would be safe for you. You can also ask your pharmacist for advice. They should be able to tell you if the herbal medicine would interfere with other medicines you’re taking. If you’re taking herbal medicines, you should let any doctor who treats you know.

Frequently asked questions

  • Complementary therapies are a group of different treatments which lie outside mainstream medical care. They include, such things as acupuncture, chiropractic, osteopathy, homeopathy and herbal medicines. The term ‘complementary’ means that they are used alongside usual medical care. If they are used instead of conventional medicine, they are known as ‘alternative’ therapies.

  • The only complementary therapists in the UK who must be registered with their professional body are osteopaths and chiropractors. Other therapists may choose to be registered. Registration helps to show that therapists are qualified, and have met a national standard of practice. For more information, see our section on How do I find a complementary therapist?

    Herbal medicines sold in the UK must be registered with The Medicines and Healthcare products Regulatory Agency. They can then be sold as traditional herbal medicines, carrying the THR mark. This helps to ensure safety and quality of the product. But see our section on herbal medicines for information about possible risks with these therapies.



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Related information

  • Discover other helpful health information websites.

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  • Reviewed by Dr Kristina Routh, Freelance Health Editor, February 2022
    Expert reviewer, Dr Adrian Raby, General Practitioner
    Next review due February 2025

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