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The Role of Complementary and Alternative Medicine (CAM) in Rheumatology — It’s Time for Integrative Medicine

Complementary and alternative medicine (CAM) is defined by the National Center for Complementary and Alternative Medicine of the US National Institutes of Health as a group of various, mostly traditional or lifestyle-based medical treatments. CAM is classified in 5 groups: (1) Biology-based therapies such as diet, natural product supplements, and herbal therapy; (2) manipulative and body-based practices; for example, massage, manual therapy, chiropractic, osteopathy, reflexology, and movement therapies, such as the Feldenkrais method or Alexander technique; (3) mind-body interventions, such as meditation, yoga, relaxation therapy, breathing techniques, biofeedback, and hypnosis; (4) energy therapies, such as therapeutic touch, prayer, reiki, and qigong, and (5) whole medical systems, such as traditional Chinese medicine, traditional Indian medicine (Ayurveda, Siddha) as well as anthroposophical medicine, naturopathy, and homeopathy.

Of note, in Germany and central Europe, naturopathy has been established as a mainstream medicine for many decades; and includes exercise, nutrition and diet, hydrotherapy, balneotherapy, and other techniques of physical therapy.

The usage and popularity of CAM have steadily increased throughout the world. CAM use is especially high in patients with chronic diseases, and musculoskeletal conditions are by far the most common reason for using such treatments1. The use of CAM is not only motivated by dissatisfaction with conventional medicine but supported by individual belief systems, their perception of being safe and “soft,” and their holistic approach. Moreover, many patients with chronic pain and rheumatic disease suffer from adverse effects of pain killers and nonsteroidal antiinflammatory drugs, which are also associated with substantial morbidity and mortality. Other patients wish to avoid or postpone invasive and surgical interventions.

Bearing in mind that third-party research funds for CAM are scarce and research structures cannot be compared to conventional disciplines, a remarkable body of evidence has been accumulated in recent years. Clearly, …