Conditions and Treatments

Complimentary and Alternative Medicine (CAM)

Complementary and alternative medicine has steadily become more widely accepted and utilized by those seeking restoration of health or wellness care. [1-6]  Kanodia, et al [7] examined the 2002 National Health Interview Survey (NHIS) data, and reported that 6% of the U.S. population had used CAM to treat back pain in 2002, and 60% of those perceived a “great deal” of benefit. There is not sufficient evidence supporting the use of CAM for the treatment of CR [8], although there is some supporting evidence for its use for related spine or pain conditions. [9-14]

The National Institutes of Health created the National Center for Complementary and Alternative Medicine (NCCAM) in 1998 [15], and funding for CAM research was accelerated by passage of the American Recovery and Reinvestment Act of 2009, which directed 31 million dollars to NCCAM for this purpose (  The Institute of Medicine’s “100 Initial Priority Topics for Comparative Effectiveness Research (CER)” contains recommendations for prioritizing CER regarding both “mindfulness based interventions…in treating pain” and “treatment strategies…for cervical disc and neck pain” in the second quartile of the list.  The inclusion of a CAM component in the treatment plan of spine patients reflects a growing trend in spine care consumer’s treatment preferences[7].

Complementary and Alternative Medicine (CAM):

CAM choices might include: (

  1. Natural Products (data not captured in this study)
  2. Mind-Body Medicine (meditation, qi gong, acupuncture, yoga, hypnotherapy, others)
  3. Manipulative and body-based systems (Chiropractic, osteopathy, massage)
  4. Energetic Systems (healing touch, Reiki, magnet, other)
  5. Movement Therapy (Feldenkrais, Alexander, other)

1. Eisenberg, D.M., et al., Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA, 1998. 280(18): p. 1569-75.

2. Fairfield, K.M., et al., Patterns of use, expenditures, and perceived efficacy of complementary and alternative therapies in HIV-infected patients. Arch Intern Med, 1998. 158(20): p. 2257-64.

3. Kaptchuk, T.J. and D.M. Eisenberg, The persuasive appeal of alternative medicine. Ann Intern Med, 1998. 129(12): p. 1061-5.

4. Krauss, H.H., et al., Alternative health care: its use by individuals with physical disabilities. Arch Phys Med Rehabil, 1998. 79(11): p. 1440-7.

5. Astin, J.A., Why patients use alternative medicine: results of a national study. JAMA, 1998. 279(19): p. 1548-53.

6. Astin, J.A., et al., A review of the incorporation of complementary and alternative medicine by mainstream physicians. Arch Intern Med, 1998. 158(21): p. 2303-10.

7. Kanodia, A.K., et al., Perceived benefit of Complementary and Alternative Medicine (CAM) for back pain: a national survey. J Am Board Fam Med, 2010. 23(3): p. 354-62.

8. Bono, e.a. Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders. Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care 2010 [cited 2010; Available from: http://

9. Roberts, D., Alternative therapies for arthritis treatment. Part 2. Orthop Nurs, 2003. 22(6): p. 412-8; quiz 419-20.

10. Roberts, D., Alternative therapies for arthritis treatment. Part 1. Orthop Nurs, 2003. 22(5): p. 335-42; quiz 343-4.

11. Snyder, M. and J. Wieland, Complementary and alternative therapies: what is their place in the management of chronic pain? Nurs Clin North Am, 2003. 38(3): p. 495-508.

12. NIH, NIH Consensus Conference. Acupuncture. JAMA, 1998. 280(17): p. 1518-24.

13. Raphael, J., et al., Cancer pain: part 2: physical, interventional and complimentary therapies; management in the community; acute, treatment-related and complex cancer pain: a perspective from the British Pain Society endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Med, 2010. 11(6): p. 872-96.

14. Gross, A., et al., Manipulation or mobilisation for neck pain: a Cochrane Review. Man Ther, 2010. 15(4): p. 315-33.

15. Harlan, W.R., Jr., Research on complementary and alternative medicine using randomized controlled trials. J Altern Complement Med, 2001. 7 Suppl 1: p. S45-52.

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