Sports Medicine: Just the Facts

CHAPTER 75 • COMPLEMENTARY AND ALTERNATIVE MEDICINE 453

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75 COMPLEMENTARY

AND ALTERNATIVE MEDICINE

Anthony I Beutler, MD

Wayne B Jonas, MD

WHAT ISCOMPLEMENTARY
ANDALTERNATIVEMEDICINE?

• Many different medical systems and medical practices
  exist in the world today including Traditional Oriental
  Medicine, Native American Practices, Ayurveda, and
  Western Biomedicine (to name only a few).
  •Western biomedicine is the medicine practiced in
  American hospitals and taught in American medical
  schools. Western biomedicine is neither the oldest nor
  the most widely used medical system in the world
  today. The World Health Organization estimates that a
  substantial portion of the world’s population receives
  their medical care outside the Western biomedical
  system. (Marty, 1997)
  
  
  • The term “Complementary and Alternative Medicine”
    or “CAM” is Western biomedicine’s term for all med-
    ical practices that lie outside its boundaries. CAM’s
    boundaries are imprecise and constantly changing as
    Western scientific methods are applied to study and
    establish the efficacy of outsidemedical practices in
    the treatment of Western biomedical disease states.
    For instance, is glucosamine supplementation for
    osteoarthritis pain a Western biomedical therapy or a
    CAM therapy? (Beutler and Jonas, 2004).
  
  
  
  

WHOUSESCOMPLEMENTARY

ANDALTERNATIVEMEDICINE?

• Many developing countries rely on CAM practices to
  provide most of the health care for their citizens.


• Americans spend more than $27 billion each year (most
  of it unreimbursed by insurance) on CAM practices.
  Visits to U.S. CAM practitioners rose from 400 million
  per year in 1990 to 600 million per year in 1996. Forty
  percent of the U.S. population and 75% of the popula-
  tion of France reported utilizing a CAM practice at least
  once during the year. (Eisenberg et al, 1998)


• Among Western CAM consumers, 95% use CAM in a
  complementary fashion or in addition to Western bio-
  medicine. Only 5% use CAM exclusively, or as an
  alternative to Western biomedicine. (Astin, 1998)


• Studies reveal that CAM users in the United States
  tend to be more educated, more affluent, more holis-
  tic in their view of wellness, and more likely to have
  chronic pain or a chronic disease than nonusers of
  CAM (Beutler and Jonas; Eisenberg et al, 1998;
  Astin, 1998). Past reports indicated that some
  minorities, such as Blacks, were less likely to use
  CAM; however, a more recent study specifically
  designed to assess CAM use among minorities found
  no difference in CAM use among ethnic groups
  (Mackenzie et al, 2003). Women consistently use
  CAM more than men.


• CAM therapies are popular for both major and minor
  illnesses. Roughly half of patients with human immun-
  odeficiency virus(HIV) and half of patients diagnosed
  with cancer will try CAM therapies to combat their ill-
  nesses; however, CAM therapies are less commonly
  used to treat diseases for which Western biomedicine
  offers safe, effective treatments. For instance, while
  57% of patients with diabetes mellitus type 2 report
  using CAM treatments, only 20% report trying CAM
  therapies to treat their diabetes (Yeh et al, 2002).

DOATHLETESUSECOMPLEMENTARY

ANDALTERNATIVEMEDICINE?

• No accurate estimate of CAM use among athletes is
  available (White, 1998); however, anecdotal evidence
  suggests extremely high rates of CAM use in athletes.