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February 23, 2005

Alternative Medicine: Herbs, Acupuncture, Massage

~by Karen Finucan Clarkson, as published in The Gazette (February 3, 2005).

Some turn to it for pain relief; others use it for stress reduction; still others rely on it simply to stay healthy. In fact, the number of Americans using complementary or alternative medicine (CAM) continues to grow, standing at 36 percent, according to a May 2004 government survey by the National Center for Complementary and Alternative Medicine (NCCAM) in Bethesda, Maryland.

CAM encompasses an aray of meical therapies ranging from acupuncture to botanical medicine to massage. Of the various alternative and complementary medical approaches noted in the survey, the use of natural products such as herbs, botanicals and enzymes is most popular. Nineteen percent of Americans partake of them. "Botanical medicine has been around for thousands of years, long before modern antibacterials: said Karen Threlkel, a naturopath in private practice at an integral medical clinic in Bethesda. A botanical is a plant or plant part - leaf, root or resin - valued for its medicinal or therapeutic properties. Herbs are a subset of botanicals.

Herbs

Some of today's most popular medicines have their roots in botanical medicine. Digitalis, a popular heart medicine, is made from the foxglove plant, she said. "You can use herbs for everything," said Threlkel. "For any illness out there, there is an herb that can help somewhat." While botanical medicine relies on science, "it is almost as much an art," she said. "Some of what we try to do is to match the energy or spirit of the plant to the energy or spirit of a person." While "no single supplement has been proven effective in a compelling way," according to the NCCAM website, "there are several supplements for which early studies yielded positive, or at least encouraging, data." That data, notes NCCAM, has resulted in ongoing multi-center trials "on ginkgo (Ginkgo bilob a) for prevention of dementia, glucosamine hydrochloride and chondroitin sulfate for osteoarthritis of the knee, Saw Palmetto (Serenoa repens)/African plum (prunus africana) for benign prostatic hypertrophy, vitamin E/Selenium for prevention of prostate cancer, shark cartilage for lung cancer, and St. John's wort (Hypericum perforatum) for major and minor depression."

Although many people self prescribe herbs, Threlkel said there are times - such as when one is pregnant or on medication - when it is especially important to seek the advice of a professional. NCCAM concurs: "...many people assume dietary supplements to be inert or at least innocuous. Yet, recent studies show clearly that interactions between these products and drugs do occur."

Herbs are available in a variety of forms - fresh or dried products; liquid or solid extracts; and tablets, capsules, powders, and tea bags. while drinking tea may not sound like a prescription for good health, it can be. A study by English researchers, in the January 26, 2005 issue of the American Chemical Society's "Journal of Agricultural and Food chemistry," found that drinking chamomile tea may help combat colds and relieve menstrual cramps. Unlike medicines, which are not standardized to a certain milligram dose, "herbs are not since they come from the whole plant," Threlkel said. The Food and Drug Administration currently regulates botanicals diferently than drug products. It is in the process of developing good manufacturing practices for these supoplements. Until they are issued, however, companies must follow eisting manufacturing requirements for foods. "I only use herbal companies that I know have a good reputation for sanitation and quality control," said Threlkel.

Homeopathy

Often confused with botanical medicine, homeopathy has been used in the U.S. since 1825. "Homeopathy is based on the principle that like cures like; it's the law of similars," said Linda Reiter, a classical homeopathic practicioner in Bowie. Homeopathic treatment involves administering extremely small, diluted doses of substances from plants, minerals, or animals that, if given in large doses to a healthy individual, would produce the same symptoms from which the sick person is suffering. "It is the energy or essence of the original substance that stimulates the body to heal," she said. In treating someone, homeopaths look beyond the current ailment and focus on the whole person, she said. With homeopathy, "everything can be treated; many things can be curred," said Reiter. Whether or not science backs Reiter's view still remains to be seen. "Research studies on homeopathy have been contradictory in their findings," notes the NCCAM website. "Some analyses have concluded that there is no strong evidence supporting homeopathy as effective for any clinical condition. However, others have found positive effects from homeopathy. The positive effects are not readily explained in scientific terms."

An initial visit to a homeopath typically runs 90 minutes to 2 hours and costs anywhere from $200-$350, according to Reiter. After the first visit, Reiter does a case work-up and uses a grid to match symptoms to remedies. "I pick the one that most closely resembles the state you're in," she said. Once a remedy is prescribed, she checks in at least once during the first week to make sure the doses and potency are right. A follow-up visit, three to four weeks later, costs roughly half of the initial screening. The remedies themselves are generally not expensive, many costing as little as $5-$10.

Massage

Massage is included on NCCAM's list of the 10 most common CAM therapies, with some 5 percent of Americans having used it. "The benefits of therapeutic massage include stress reduction, relief from pain, improved circulation and flexibility, and a stronger immune system," said Renee Lafferman, who works with the complementary therapies program at Frederick Memorial Hospital's Wellness Center.

One of the most popular types of massage is Swedish, which uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles and follows the direction of blood flow toward the heart. It can be a relatively vigorous form of massage. Swedish massage stimulates the release of endorphins, the body's own "feel good" chemicals, to help induce relaxation, relieve pain, and reduce levels of chemicals associated with stress, said Lafferman. Massage also stimulates blood circulation to improve the supply of oxygen and nutrients to body tissues and helps the lymphatic system flush away waste products. It eases tense and knotted muscles and stiff joints, improving mobility and flexibility, she said. Massages at the wellness center cost $35 for a half=hour session; $65 for an hour; and $90 for 90 minutes.

Sorting through the various types of massages can be confusing. "It's a good idea to speak to the business manager of a wellness center so you can select the modality that fits your personality or need," said Judy LeGrand, a certified massage therapist and co-owner of Relaxing Alternatives Wellness Center in Gaithersburg. "Reflexology is a hard, deliberate massage," said LeGrand. It is also a particularly good massage choice for those uncomfortable disrobing, she said. "It is a good adjunct for diabetics in that it helps with the circulation in the feet." LeGrand also practices shiatsu, a whole body massage that is done with clothes on. This massage uses a lighter touch and is especially good for pregnant women and people with back and hip issues, she said. While LeGrand recommends an hour massage for optimal benefit, Relaxing Alternatives offers 30-minute sessions for $40 and 60-minute sessions for $70.

Acupuncture

"Pain, physical pain, is what brings the majority of people to me," said Laura Mannis, an acupuncturist at the Center for Mind-Body Therapies in Frederick. While acupuncture can provide pain relief, it can do more than that, according to Mannis. People suffering from a variety of acute and chronic ailments can see improvement in their situations, she said.

The World Health Organization, in an analysis of controlled clinical trials published through early 1999, identified 28 conditions for which acupuncture has been proven to be an effective treatment. These ailments include hay fever, depression, hypertension, sciatica, and stroke. It lists another 63 conditions "for which the therapeutic effect of acupuncture has been shown but for which further proof is needed." Acupuncturists place small, fine needles along specific meridians that are associated with organs or organ functions to restore the flow of energy throughout the body, said Mannis. Although needles are used, there is little pain associated with acupuncture, she said, although some people might experience a slight tingling or fleeting sharpness as the needles are inserted. "I've had many patients fall asleep or tell me that it is an extremely relaxing experience," she said.

The needles slide tissue, they don't cut it," said Edna Brant, a licensed acupuncturist in Laurel. Brandt treats a range of people - from those in their 80s to young children. "I've had a lot of success treating kids for bed wetting and ADD," she said. An initial visit with an acupuncturist takes roughly two hours, according to both Mannis and Brandt, and costs between $125 and $150. Follow-up visits, which may occur as often as several times a week for those with chronic conditions, run $70 to $80.

Like many CAM practitioners, Mannis noted that, "People frequently come to me for something acute, but they end up staying for the broader - you might say emotional and spiritual - benefits from the treatment."

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