Whole medical systems for relief of back pain

Many are traditional systems of medicine that are practiced by individual cultures throughout the world. Major Eastern whole medical systems include Traditional Chinese medicine (TCM) and Ayurvedic medicine, one of India’s traditional systems of medicine. Major Western whole medical systems include Homeopathy and Naturopathy. Other systems have been developed by Native American, African, Middle Eastern, Tibetan, and Central and South American cultures.

Traditional Chinese Medicine

TCM is a complete system of healing that dates back to 200 B.C. in written form. Korea, Japan and Vietnam have all developed their own unique versions of traditional medicine based on practices originating in China.

In the TCM view, the body is a delicate balance of two opposing and inseparable forces: yin and yang. Yin represents the cold, slow, or passive principle, while yang represents the hot, excited, or active principle. Among the major assumptions in TCM are that health is achieved by maintaining the body in a ‘balanced state’ and that disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi (or vital energy) and of blood along pathways known as meridians.

TCM practitioners typically use herbs, acupuncture, and massage to help unblock qi and blood in patients in an attempt to bring the body back into harmony and wellness.

Treatments in TCM are typically tailored to the subtle patterns of disharmony in each patient and are based on an individualized diagnosis. The diagnostic tools differ from those of conventional medicine. There are three main therapeutic modalities:

1. Acupuncture and moxibustion (moxibustion is the application of heat from the burning of the herb moxa at the acupuncture point)
2. Chinese Materia Medica (the catalogue of natural products used in TCM)
3. Massage and manipulation

Although TCM proposes that natural products catalogued in Chinese Materia Medica or acupuncture can be used alone to treat virtually any illness, quite often they are used together and sometimes in combination with other modalities (e.g., massage, moxibustion, diet changes, or exercise).

Ayurvedic Medicine

Ayurveda, which literally means ‘the science of life,’ is a natural healing system developed in India. Ayurvedic texts claim that the sages who developed India’s original systems of meditation and yoga developed the foundations of this medical system. It is a comprehensive system of medicine that places equal emphasis on the body, mind, and spirit, and strives to restore the innate harmony of the individual. Some of the primary Ayurvedic treatments include diet, exercise, meditation, herbs, massage, exposure to sunlight, and controlled breathing. In India, Ayurvedic treatments have been developed for various diseases (e.g., diabetes, cardiovascular conditions, and neurological disorders). However, a survey of the Indian medical literature indicates that the quality of the published clinical trials generally falls short of contemporary methodological standards with regard to criteria for randomization, sample size, and adequate controls.

Naturopathy

Naturopathy is a system of healing, originating from Europe, that views disease as a manifestation of alterations in the processes by which the body naturally heals itself. It emphasizes health restoration as well as disease treatment. The term ‘naturopathy’ literally translates as ‘nature disease.’ Today naturopathy, or naturopathic medicine, is practiced throughout Europe, Australia, New Zealand, Canada, and the United States. There are six principles that form the basis of naturopathic practice in North America (not all are unique to naturopathy);

1. The healing power of nature
2. Identification and treatment of the cause of disease
3. The concept of ‘first do no harm’
4. The doctor as teacher
5. Treatment of the whole person
6. Prevention

The core modalities supporting these principles include diet modification and nutritional supplements, herbal medicine, acupuncture and Chinese medicine, hydrotherapy, massage and joint manipulation, and lifestyle counseling. Treatment protocols combine what the practitioner deems to be the most suitable therapies for the individual patient.

As of this writing, virtually no research studies on naturopathy as a complete system of medicine have been published. A limited number of studies on botanicals in the context of use as naturopathic treatments have been published.

Homeopathy

Homeopathy is a complete system of medical theory and practice. Its founder, German physician Samuel Christian Hahnemann (1755-1843), hypothesized that one can select therapies on the basis of how closely symptoms produced by a remedy match the symptoms of the patient”s disease. He called this the “principle of similars.” Hahnemann proceeded to give repeated doses of many common remedies to healthy volunteers and carefully record the symptoms they produced.

This procedure is called a “proving” or, in modern homeopathy, a “human pathogenic trial.” As a result of this experience, Hahnemann developed his treatments for sick patients by matching the symptoms produced by a drug to symptoms in sick patients. Hahnemann emphasized from the beginning carefully examining all aspects of a person”s health status, including emotional and mental states, and tiny idiosyncratic characteristics.

Since homeopathy is administered in minute or potentially nonexistent material dosages, there is a skepticism in the scientific community about its efficacy. Nonetheless, the medical literature provides evidence of ongoing research in the field.

Studies of homeopathy’s effectiveness involve three areas of research:

• Comparisons of homeopathic remedies and placebos
• Studies of homeopathy”s effectiveness for particular clinical conditions
• Studies of the biological effects of potencies, especially ultra-high dilutions.

Five systematic reviews and meta-analyses evaluated clinical trials of the effectiveness of homeopathic remedies as compared with placebo. The reviews found that, overall, the quality of clinical research in homeopathy is low. But when high-quality studies were selected for analysis, a surprising number showed positive results.

Overall, clinical trial results are contradictory, and systematic reviews and meta-analyses have not found homeopathy to be a definitively proven treatment for any medical condition.

Summary

While whole medical systems differ in their philosophical approaches to the prevention and treatment of disease, they share a number of common elements. These systems are based on the belief that one”s body has the power to heal itself. Healing often involves marshalling multiple techniques that involve the mind, body, and spirit. Treatment is often individualized and dependent on the presenting symptoms. To date, NCCAM”s research efforts have focused on individual therapies with adequate experimental rationale and not on evaluating whole systems of medicine as they are commonly practiced.