Many Americans use medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine.

Complementary medicine is used together with mainstream medical care. An example is using acupuncture to help with side effects of cancer treatment. When health care providers and facilities offer both types of care, it is called integrative medicine. Alternative medicine is used instead of mainstream medical care.

The claims that non-mainstream practitioners make can sound promising. However, researchers do not know how safe many of these treatments are or how well they work. Studies are underway to determine the safety and usefulness of many of these practices.

To minimize the health risks of a non-mainstream treatment

• Discuss it with your doctor. It might have side effects or interact with other medicines.
• Find out what the research says about it
• Choose practitioners carefully
• Tell all of your doctors and practitioners about all of the different types of treatments you use

“Complementary and alternative medicine,” “complementary medicine,” “alternative medicine,” “”—you may have seen these terms on the Internet and in marketing, but what do they really mean? While the terms are often used to mean the array of health care approaches with a history of use or origins outside of , they are actually hard to define and may mean different things to different people.

The terms complementary and integrative refer to the use of non-mainstream approaches together with conventional medical approaches.

Alternative health approaches refer to the use of non-mainstream products or practices in place of . NCCIH advises against using any product or practice that has not been proven safe and effective as a substitute for conventional medical treatment or as a reason to postpone seeing your health care provider about any health problem. In some instances, stopping—or not starting—conventional treatment can have serious consequences. Before making a decision not to use a proven conventional treatment, talk to your health care providers.

We’ve all seen the words “complementary,” “alternative,” and “integrative,” but what do they really mean?

This fact sheet looks into these terms to help you understand them better and gives you a brief picture of the mission and role of the National Center for Complementary and Integrative Health (NCCIH) in this area of research. The terms “complementary,” “alternative,” and “integrative” are continually evolving, along with the field, but the descriptions of these terms below are how we at NIH currently define them.

Complementary Versus Alternative

According to a 2012 national survey, many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice. When describing these approaches, people often use “alternative” and “complementary” interchangeably, but the two terms refer to different concepts:

• If a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.”
• If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.”

Most people who use non-mainstream approaches also use conventional health care.

In additional to complementary and alternative, you may also hear the term “functional medicine.” This term sometimes refers to a concept similar to integrative health (described below), but it may also refer to an approach that more closely resembles naturopathy (a medical system that has evolved from a combination of traditional practices and health care approaches popular in Europe during the 19th century).

Integrative Health

Integrative health brings conventional and complementary approaches together in a coordinated way. Integrative health also emphasizes multimodal interventions, which are two or more interventions such as conventional medicine, lifestyle changes, physical rehabilitation, psychotherapy, and complementary health approaches in various combinations, with an emphasis on treating the whole person rather than, for example, one organ system. Integrative health aims for well-coordinated care among different providers and institutions by bringing conventional and complementary approaches together to care for the whole person.

The use of integrative approaches to health and wellness has grown within care settings across the United States. Researchers are currently exploring the potential benefits of integrative health in a variety of situations, including pain management for military personnel and veterans, relief of symptoms in cancer patients and survivors, and programs to promote healthy behaviors.

Complementary Health Approaches

Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be:

• Nutritional (e.g., special diets, dietary supplements, herbs, probiotics, and microbial-based therapies).
• Psychological (e.g., meditation, hypnosis, music therapies, relaxation therapies).
• Physical (e.g., acupuncture, massage, spinal manipulation).
• Combinations such as psychological and physical (e.g., yoga, tai chi, dance therapies, some forms of art therapy) or psychological and nutritional (e.g., mindful eating).

Nutritional approaches include what NCCIH previously categorized as natural products, whereas psychological and/or physical approaches include what was referred to as mind and body practices.

Examples of complementary health approaches that fall within the categories: Psychological, Physical, and Nutritional

What’s the Bottom Line?

How much do we know about complementary health approaches for children?

We know a lot about the usage rates of complementary health approaches for children but little about their effects and safety.¹

What do we know about the effectiveness of complementary health approaches for children?

Studies have looked at many complementary health approaches for children with different conditions, but the evidence generally isn’t strong enough to show what works and what doesn’t.

What do we know about the safety of complementary health approaches for children?

Many complementary approaches haven’t been tested for safety in children.

¹ In the past, children were often excluded from research studies due to special protections, and findings from studies of adults were applied to children. Today, the National Institutes of Health requires that children be included in all studies, unless there are scientific and ethical reasons not to.

Patterns in the Use of Complementary Health Approaches for Children

The 2012 National Health Interview Survey (NHIS) included a comprehensive survey on the use of complementary health approaches by almost 45,000 Americans, including more than 10,000 children aged 4 to 17. The survey found that 11.6 percent of the children had used or been given some form of complementary health product or practice, such as yoga or dietary supplements, during the past year. Data from the 2017 NHIS found that from 2012 to 2017 the use of yoga and meditation in the past 12 months significantly increased among U.S. children (aged 4 to 17 years). The percentage of children using yoga more than doubled and the percentage of children meditating showed an almost tenfold increase.

The most frequently used approaches for children were natural products² (fish oil, melatonin, and probiotics), and chiropractic or osteopathic manipulation.

For children, complementary health approaches were most often used for back or neck pain, other musculoskeletal conditions, head or chest colds, anxiety or stress, attention-deficit hyperactivity disorder (ADHD) or attention-deficit disorder (ADD), and insomnia or trouble sleeping.

For more information from the NHIS study on children’s use of complementary health approaches, including natural products and mind and body practices, visit the National Center for Complementary and Integrative Health’s (NCCIH) NHIS Statistics pages at nccih.nih.gov/research/statistics/NHIS/2012.

² This does not include vitamins and minerals.

Other studies show that children in the United States who use or are given complementary health approaches vary in age and health status. For example:

• About 10 percent of infants are given teas or botanical supplements, usually for fussiness or stomach problems.
• About 40 percent of children aged 2 to 8 are given dietary supplements containing vitamins or minerals. However, that age group generally eats a nutritionally adequate diet.
• Teens are particularly likely to use products that claim to improve sports performance, increase energy levels, or promote weight loss.
• Children with chronic medical conditions, including anxiety, musculoskeletal conditions, and recurrent headaches, are more likely than other children to use complementary health approaches, usually along with conventional care.

What the Science Says About the Safety and Side Effects of Complementary Health Approaches for Children

• Dietary supplements result in about 23,000 emergency room visits every year. Many of the patients are young adults who come to the emergency room with heart problems from taking weight-loss or energy products. One-fifth of the visits are children; most of whom took a vitamin or mineral when unsupervised. (Child-resistant packaging isn’t required for dietary supplements.)
• Some dietary supplements contain contaminants, including drugs, chemicals, or metals.
• Children’s small size, developing organs, and immature immune system make them more vulnerable than adults to having allergic or other adverse reactions to dietary supplements.
• Some products may worsen conditions. For example, echinacea is a type of ragweed so people sensitive to ragweed may also react to echinacea.
• Do not rely on asthma products sold over-the-counter and labeled as homeopathic, the U.S. Food and Drug Administration (FDA) warns. Homeopathic remedies and dietary supplements are not evaluated by the FDA for safety or effectiveness.
• Biofeedback, guided imagery, hypnosis, mindfulness, and yoga are some of the mind and body practices that have the best evidence of being effective for children for various symptoms (such as anxiety and stress) and are low-risk. However, spinal manipulation, a common complementary approach, is associated with rare but serious complications.

More to Consider

• Make sure that your child has received an accurate diagnosis from a licensed health care provider.
• Educate yourself about the potential risks and benefits of complementary health approaches.
  • Ask your child’s health care provider about the effectiveness and possible risks of approaches you’re considering or already using for your child.
• Remind your teenagers to talk to their health care providers about any complementary approaches they may use.
• Do not replace or delay conventional care or prescribed medications with any health product or practice that hasn’t been proven safe and effective.
• If a health care provider suggests a complementary approach, do not increase the dose or duration of the treatment beyond what is recommended (more isn’t necessarily better).
• If you have any concerns about the effects of a complementary approach, contact your child’s health care provider.
• As with all medications and other potentially harmful products, store dietary supplements out of the sight and reach of children.
• The NCCIH Web site offers safety tips on dietary supplements and mind and body practices for children and teens.
• Tell all your child’s health care providers about any complementary or integrative health approaches your child uses. Give them a full picture of what you do to manage your child’s health. This will help ensure coordinated and safe care.

Selecting a Complementary Health Practitioner

If you’re looking for a complementary health practitioner for your child, be as careful and thorough in your search as you are when looking for conventional care. Be sure to ask about the practitioner’s:

• Experience in coordinating care with conventional health care providers.
• Experience in delivering care to children.
• Education, training, and license. For more information on credentialing, see the NCCIH Web site.

According to a 2012 national survey, nearly 12 percent of children and teens (about one in nine) in the United States are using some form of complementary health product or practice, such as chiropractic or spinal manipulation, yoga, meditation, or massage therapy. Mind and body practices include a variety of procedures and techniques done or taught by a trained practitioner or teacher to help improve health and well-being. Older children and teens can do some mind and body activities on their own (or with help from a parent or guardian), such as relaxation techniques and deep breathing. Mind and body practices are generally safe if used appropriately, but the number of studies looking at their safety specifically for children is limited.

Here are 7 things to know about common mind and body practices for children and teens.

1. Biofeedback, guided imagery, mindfulness, and yoga are some of the mind and body practices that have the best evidence of being effective for children and are low-risk.

2. Acupuncture appears to be safe for most children, but side effects can occur if it’s done by poorly trained practitioners.

3. Massage therapy appears to have few risks when done by a trained practitioner. However, massage therapists need to take extra precautions with people who have certain health conditions, such as bleeding disorders.

4. Relaxation techniques are generally safe for healthy people, including children. However, there have been rare reports that some relaxation techniques might cause or worsen symptoms in people with epilepsy or certain psychiatric conditions, or with a history of abuse or trauma.

5. Spinal manipulation is usually safe for healthy people but is also associated with rare but serious complications.

6. Follow the Centers for Disease Control and Prevention’s vaccination recommendations to safeguard your child against vaccine-preventable diseases. Vaccinating children helps protect our community’s and our children’s health.

7. It’s important that you talk with your child’s health care provider about any complementary health approach that you’re using or considering for your child, and encourage your teenagers to do the same.

This group includes a variety of products, such as herbs (also known as botanicals), vitamins and minerals, and probiotics. They are widely marketed, readily available to consumers, and often sold as dietary supplements.

According to the 2012 National Health Interview Survey (NHIS), which included a comprehensive survey on the use of complementary health approaches by Americans, 17.7 percent of American adults had used a dietary supplement other than vitamins and minerals in the past year. These products were the most popular complementary health approach in the survey. (See chart.) The most commonly used natural product was fish oil.

Researchers have done large, rigorous studies on a few natural products, but the results often showed that the products didn’t work for the conditions studied. Research on others is in progress. While there are indications that some may be helpful, more needs to be learned about the effects of these products in the human body, and about their safety and potential interactions with medicines and other natural products.

Complementary physical and/or psychological approaches include tai chi, yoga, acupuncture, massage therapy, spinal manipulation,art therapy, music therapy, dance, mindfulness-based stress reduction, and many others. These approaches are often administered or taught by a trained practitioner or teacher. The 2012 NHIS showed that yoga, chiropractic and osteopathic manipulation, and meditation are among the most popular complementary health approaches used by adults. According to the 2017 NHIS, the popularity of yoga has grown dramatically in recent years, from 9.5 percent of U.S. adults practicing yoga in 2012 to 14.3 percent in 2017. The 2017 NHIS also showed that the use of meditation increased more than threefold from 4.1 percent in 2012 to 14.2 percent in 2017.

Other psychological and physical approaches include relaxation techniques (such as breathing exercises and guided imagery), qi gong, hypnotherapy, Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration, and Trager psychophysical integration.

Research findings suggest that several psychological and physical approaches, alone or in combination, are helpful for a variety of conditions. A few examples include the following:

• Acupuncture may help ease types of pain that are often chronic, such as low-back pain, neck pain, and osteoarthritis/knee pain. Acupuncture may also help reduce the frequency of tension headaches and prevent migraine headaches.
• Meditation may help reduce blood pressure, symptoms of anxiety and depression, and symptoms of irritable bowel syndrome and flare-ups in people with ulcerative colitis. Meditation may also benefit people with insomnia.
• Tai chi appears to help improve balance and stability, reduce back pain and pain from knee osteoarthritis, and improve quality of life in people with heart disease, cancer, and other chronic illnesses.
• Yoga may benefit people’s general wellness by relieving stress, supporting good health habits, and improving mental/emotional health, sleep, and balance. Yoga may also help with low-back pain and neck pain, anxiety or depressive symptoms associated with difficult life situations, quitting smoking, and quality of life for people with chronic diseases.

The amount of research on psychological and physical approaches varies widely depending on the practice. For example, researchers have done many studies on acupuncture, yoga, spinal manipulation, and meditation, but there have been fewer studies on some other approaches.

Other Complementary Health Approaches

Some complementary approaches may not neatly fit into either of these groups—for example, the practices of traditional healers, Ayurvedic medicine, traditional Chinese medicine, homeopathy, naturopathy, andfunctional medicine.

While scientific evidence now exists regarding the effectiveness and safety of some complementary health approaches, there remain many yet-to-be-answered questions about whether others are safe, whether they work for the diseases or medical conditions for which they are promoted, and how those approaches with health benefits may work. As the Federal Government’s lead agency for scientific research on health interventions, practices, products, and disciplines that originate from outside , NCCIH supports scientific research to answer these questions and determine who might benefit most from the use of specific approaches.

Are You Considering a Complementary Health Approach?

Millions of Americans use complementary health approaches. Like any decision concerning your health, decisions about whether to use complementary approaches are important. The National Center for Complementary and Integrative Health (NCCIH) has developed this fact sheet to assist you in your decision-making about complementary health products and practices.

Take Charge of Your Health

• Be an informed consumer. Find out and consider what scientific studies have been done on the safety and effectiveness of any health approach that is recommended to or interests you.
• Discuss the information and your interests with your health care providers before making a decision.
• Choose a complementary health practitioner, such as an acupuncturist, as carefully as you would choose a conventional health care provider.
• Before using any dietary supplement or herbal product, make sure you find out about potential side effects or interactions with medications you may be taking.
• Only use treatments for your condition that have been proven safe. Do not use a product or practice that has not been proven to be effective to postpone seeing your health care provider for your condition.
• Tell all your health care providers—complementary and conventional—about all the health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

It's important to learn what scientific studies have discovered about the complementary health approach you're considering. Evidence from research studies is stronger and more reliable than something you've seen in an advertisement or on a Web site, or something someone told you about that worked for them. (For tips on how to evaluate Web site information, see the NCCIH fact sheet Finding and Evaluating Online Resources on Complementary Health Approaches.)

Understanding a product's or practice's potential benefits, risks, and scientific evidence is critical to your health and safety. Scientific research on many complementary health approaches is relatively new, so this kind of information may not be available for each one. However, many studies are under way, including those that NCCIH supports, and knowledge and understanding of complementary approaches are increasing all the time. Here are some ways to find reliable information:

• Talk with your health care providers. Tell them about the complementary health approach you're considering and ask any questions you may have about safety, effectiveness, or interactions with medications (prescription or nonprescription) or dietary supplements.
• Visit the NCCIH Web site (nccih.nih.gov). The “Health Information” page has an A-Z list of complementary health products and practices, which describes what the science says about them, and links to other objective sources of online information. The Web site also has contact information for the NCCIH Clearinghouse, where information specialists are available to assist you in searching the scientific literature and to suggest useful NCCIH publications. You can also find information from NCCIH on Facebook (www.facebook.com/nih.nccih), Twitter (www.twitter.com/nih_nccih), YouTube (www.youtube.com/c/nih_nccih), and Pinterest (www.pinterest.com/nccih).
• Visit your local library or a medical library. Ask the reference librarian to help you find scientific journals and trustworthy books with information on the product or practice that interests you.

Before you begin using a complementary health approach, it’s a good idea to ask the following questions:

• Is there scientific evidence (not just personal stories) to back up the statements?
• What is the source? Statements that manufacturers or other promoters of some complementary health approaches may make about effectiveness and benefits can sound reasonable and promising. However, the statements may be based on a biased view of the available scientific evidence.
• Does the Federal Government have anything to report about the product or practice?
  • Visit the NCCIH Web site or contact the NCCIH Clearinghouse to see if NCCIH has information about the product or practice.
  • Visit the U.S. Food and Drug Administration (FDA) online at www.fda.gov/ to see if there is any information available about the product or practice.
  • Information specifically about dietary supplements can be found on the FDA’s Web site at www.fda.gov/Food/DietarySupplements/ and on the Web site of the National Institutes of Health (NIH) Office of Dietary Supplements at ods.od.nih.gov/.
  • Visit the FDA's Web page on recalls and safety alerts at www.fda.gov/Safety/Recalls/. The FDA has a rapid public notification system to provide information about tainted dietary supplements. See www.fda.gov/AboutFDA/ContactFDA/StayInformed/RSSFeeds/TDS/rss.xml.
  • Check with the Federal Trade Commission at www.ftc.gov to see if there are any enforcement actions for deceptive advertising regarding the therapy. Also, visit the site’s Consumer Information section at www.consumer.ftc.gov.
• How does the provider or manufacturer describe the approach?
  • Beware of terms like “scientific breakthrough,” “miracle cure,” “secret ingredient,” or “ancient remedy.”
  • If you encounter claims of a “quick fix” that depart from previous research, keep in mind that science usually advances over time by small steps, slowly building an evidence base.
  • Remember: if it sounds too good to be true—for example, claims that a product or practice can cure a disease or works for a variety of ailments—it usually is.

Is That Health Web Site Trustworthy?

If you're visiting a health Web site for the first time, these five quick questions can help you decide whether the site is a helpful resource.

Who? Who runs the Web site? Can you trust them?

What? What does the site say? Do its claims seem too good to be true?

When? When was the information posted or reviewed? Is it up-to-date?

Where? Where did the information come from? Is it based on scientific research?

Why? Why does the site exist? Is it selling something?

Are You Reading Real Online News or Just Advertising?

In April 2011, the Federal Trade Commission warned the public about fake online news sites promoting an acai berry weight-loss product. For example, one described an investigation in which a reporter used the product for several weeks, with “dramatic” results. The site looked real, but it was actually an advertisement. Everything was fake: there was no reporter, no news organization, and no investigation. The only real things were the links to a sales site that appeared in the story and elsewhere on the Web page. Similar fake news sites have promoted other products, including work-at-home opportunities and debt reduction plans.

You should suspect that a news site may be fake if it:

• Endorses a product. Real news organizations generally don’t do this.
• Only quotes people who say good things about the product.
• Presents research findings that seem too good to be true or fail to point out any limitations in research. (If something seems too good to be true, it usually is.)
• Contains links to a sales site.
• Includes positive reader comments only, and you can’t add a comment of your own.

How To Protect Yourself

If you suspect that a news site might be fake, look for a disclaimer somewhere on the page (often in small print) that indicates that the site is an advertisement. Also, don't rely on Internet news reports when making important decisions about your health. If you're considering a health product described in the news, discuss it with your health care provider.

When patients tell their providers about their use of complementary health practices, they can better stay in control and more effectively manage their health. When providers ask their patients, they can ensure that they are fully informed and can help patients make wise health care decisions.

Here are 4 tips to help you and your health care providers start talking:

1. List the complementary health practices you use on your patient history form. When completing the patient history form, be sure to include everything you use—from acupuncture to zinc. It’s important to give health care providers a full picture of what you do to manage your health.

2. At each visit, be sure to tell your providers about what complementary health approaches you are using. Don’t forget to include over-the-counter and prescription medicines, as well as dietary and herbal supplements. Make a list in advance and take it with you. Some complementary health approaches can have an effect on conventional medicine, so your provider needs to know.

3. If you are considering a new complementary health practice, ask questions. Ask your health care providers about its safety, effectiveness, and possible interactions with medications (both prescription and nonprescription).

4. Don’t wait for your providers to ask about any complementary health practice you are using. Be proactive. Start the conversation.

If you’re looking for a complementary health practitioner to help treat a medical problem, it is important to be as careful and thorough in your search as you are when looking for conventional care.

Here are some tips to help you in your search:

1. If you need names of practitioners in your area, first check with your doctor or other health care provider. A nearby hospital or medical school, professional organizations, state regulatory agencies or licensing boards, or even your health insurance provider may be helpful. Unfortunately, the National Center for Complementary and Integrative Health (NCCIH) cannot refer you to practitioners.

2. Find out as much as you can about any potential practitioner, including education, training, licensing, and certifications. The credentials required for complementary health practitioners vary tremendously from state to state and from discipline to discipline.

   Once you have found a possible practitioner, here are some tips about deciding whether he or she is right for you:

3. Find out whether the practitioner is willing to work together with your conventional health care providers. For safe, coordinated care, it’s important for all of the professionals involved in your health to communicate and cooperate.

4. Explain all of your health conditions to the practitioner, and find out about the practitioner’s training and experience in working with people who have your conditions. Choose a practitioner who understands how to work with people with your specific needs, even if general well-being is your goal. And, remember that health conditions can affect the safety of complementary approaches; for example, if you have glaucoma, some yoga poses may not be safe for you.

5. Don’t assume that your health insurance will cover the practitioner’s services. Contact your health insurance provider and ask. Insurance plans differ greatly in what complementary health approaches they cover, and even if they cover a particular approach, restrictions may apply.

6. Tell all your health care providers about the complementary approaches you use and about all practitioners who are treating you. Keeping your health care providers fully informed helps you to stay in control and effectively manage your health.

As with any medical product or treatment, there can be risks with complementary approaches. These risks depend on the specific product or practice. Each needs to be considered on its own. However, if you're considering a specific product or practice, the following general suggestions can help you think about safety and minimize risks.

• Be aware that individuals respond differently to health products and practices, whether conventional or complementary. How you might respond to one depends on many things, including your state of health, how you use it, or your belief in it.
• Keep in mind that “natural” does not necessarily mean “safe.” (Think of mushrooms that grow in the wild: some are safe to eat, while others are not.)
• Learn about factors that affect safety. For a practice that is administered by a practitioner, such as , these factors include the training, skill, and experience of the practitioner. For a product such as a dietary supplement, the specific ingredients and the quality of the manufacturing process are important factors.
• If you decide to use a practice provided by a complementary health practitioner, choose the practitioner as carefully as you would your primary health care provider. (To learn more, see NCCIH's 6 Things To Know When Selecting a Complementary Health Practitioner.)
• If you decide to use a dietary supplement, such as an herbal product, be aware that some products may interact in harmful ways with medications (prescription or over-the-counter) or other dietary supplements, and some may have side effects on their own. (To learn more, see the NCCIH fact sheet Using Dietary Supplements Wisely.)
• Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

As with any treatment, it is important to consider safety before using complementary health products and practices. Safety depends on the specific therapy, and each complementary product or practice should be considered on its own.

Mind and body practices such as meditation and yoga, for example, are generally considered to be safe in healthy people when practiced appropriately. Natural products such as herbal medicines or botanicals are often sold as dietary supplements and are readily available to consumers; however, there is a lot we don’t know about the safety of many of these products, in part because a manufacturer does not have to prove the safety and effectiveness of a dietary supplement before it is available to the public.

Two of the main safety concerns for dietary supplements are

• The possibilities of drug interactions—for example, research has shown that St. John’s wort interacts with drugs such as antidepressants in ways that can interfere with their intended effects
• The possibilities of product contamination—supplements have been found to contain hidden prescription drugs or other compounds, particularly in dietary supplements marketed for weight loss, sexual health including erectile dysfunction, and athletic performance or body-building.

Looking to add a complementary health treatment—like yoga or meditation—to your pain management approach?

Before you dive in, make sure to check with your health care provider. Complementary health approaches are generally safe, but you have to make sure the approach you choose is safe for you and performed correctly. For treatments such as acupuncture or massage, be sure you are treated by a professional.

To help you get started, here are overviews of five types of complementary health treatments, with helpful information in part from the National Center for Complementary and Integrative Health's (NCCIH) "Pain: Considering Complementary Approaches" e-book.

Acupuncture. Acupuncture uses needles to stimulate specific areas of the body to reduce pain. As part of the National Institutes of Health's Helping to End Addiction Long-term Initiative, NCCIH-supported researchers study how acupuncture can help older adults with chronic low back pain. Other research has found that acupuncture can help with fibromyalgia pain, knee pain, and headaches.

Spinal manipulation. Spinal manipulation is one of the most commonly used complementary health treatments in the U.S. It involves a chiropractor or other health professional applying a controlled force to the joints of the spine using their hands or a device. Spinal manipulation may be a helpful nondrug treatment for people with chronic low back pain. It may also help relieve headaches, including migraines.

Meditation and mindfulness. Meditation can involve focusing your mind on a particular sensation (such as breathing), a sound, a repeated word or phrase, or an image. Mindfulness helps you focus your attention or awareness on the present moment. Recent research supported by NCCIH has shown that using mindfulness to help patients with chronic pain and dependence on opioids has promise.

Yoga. Yoga is a series of poses, movements, and deep-breathing exercises. It often combines deep breathing and meditation. Studies show that yoga can be helpful for low back pain, with effects similar to those of exercise. Research on yoga for neck pain and arthritis has been limited, but some studies have had promising results, according to NCCIH.

Dietary supplements and natural products. According to NCCIH, natural products used in complementary health include herbs, vitamins, minerals, and probiotics. These products are often marketed as dietary supplements. The U.S. Food and Drug Administration regulates dietary supplements, but the regulations are different from those for prescription medicines. Early results of studies using probiotics to ease irritable bowel syndrome pain have been promising. And omega-3 fatty acids, like those found in fish oil, may help rheumatoid arthritis symptoms.

What does “homeopathic” mean?

Homeopathic medicine is an alternative medical system that was developed in Germany more than 200 years ago and is based in part on the principle called “law of minimum dose,” which is the notion that the lower the dose of the medication, the greater its effectiveness. Many homeopathic remedies are so diluted that no molecules of the original substance remain; however, some products labeled as “homeopathic” can contain substantial amounts of active ingredients and therefore could cause side effects and drug interactions. The U.S. Food and Drug Administration has warned consumers about different products labeled as homeopathic.

What does “holistic” mean?

The word holistic (sometimes spelled wholistic) often refers to the treatment of the whole person—body, mind, emotions, and spirit—to achieve wellness and good health. People who practice holistic medicine may use conventional medications to treat a person’s ailment, but they will take into consideration other factors such as sleep habits, lifestyle, stress, and diet to improve health and relieve symptoms.

What does “natural” mean?

When it comes to medicine, there is no official definition for use of the term natural. And it’s important to know that a medicinal product labeled natural does not always mean safe. For example, the herbs comfrey and kava may be considered natural products, but they can cause serious harm to the liver. An herbal or botanical supplement labeled natural may contain dozens of chemical compounds and all of its individual components may not be known.

What does “naturopathic” mean?

Naturopathic medicine is a medical system that has evolved from a combination of traditional practices and health care approaches popular in Europe during the 19th century. In the United States, naturopathic practitioners use many different treatment approaches, including dietary and lifestyle changes, stress reduction or relaxation techniques, herbs or botanicals, dietary supplements, and other natural products, homeopathy, manipulative therapies, counseling, conventional medicine, and others.

What does “complementary health approaches” mean?

Complementary health approaches include a broad range of practices, interventions, and natural products, which are not typically part of conventional medical care, or which may have origins outside of usual Western practice. Complementary health approaches can be roughly divided into two major groups—mind and body practices, and natural products

What does “alternative medicine” mean?

Like complementary health approaches, alternative medicine are products or practices developed outside of mainstream Western, or conventional, medicine, but they are used in place of conventional medicine.