Symposium Issue - JAMA November 11, 1998

Eisenberg  report that the prevalence of use of at least 1 of 16 specific alternative therapies during the previous 12 months has increased significantly (from 33.8% in 1990 to 42.1% in 1997), that the estimated number of visits to alternative medicine practitioners increased dramatically (from 427 million in 1990 to 629 million in 1997), and that only 38.5% of those who used alternative therapies discussed them with their physician.

Total out-of-pocket expenditures associated with use of alternative medicine in 1997 were estimated at $27 billion. In an analysis of data from malpractice insurers from 1990 through 1996, Studdert and colleagues found that claims against chiropractors, massage therapists, and acupuncturists generally occurred less frequently and usually involved less severe injury than claims against medical doctors.

This issue of THE JOURNAL includes 6 randomized clinical trials that evaluate the use of 6 diverse alternative medicine herapies for treatment of common clinical conditions. The results are intriguing:

Bove and Nilsson report that chiropractic spinal manipulation is not effective for episodic tension headache.

Cardini  found that moxibustion (stimulation of an acupuncture point by heat generated from burning a specific herb) is helpful for correction of breech presentation in late pregnancy.

Bensoussan document that a Chinese herbal medicine formulation improves symptoms of irritable bowel syndrome.

Shlay demonstrate that acupuncture is no more effective than amitriptyline or placebo for relieving pain due to human immunodeficiency virus-related peripheral neuropathy.

Heymsfield determined that Garcinia cambogia, a common component of commercial weight-loss products, lacks efficacy as an antiobesity agent.

In a preliminary study, Garfinkel and rreport that a yoga-based intervention appears to hold promise for relieving some symptoms of carpal tunnel syndrome.

In addition, a ystematic review by Wilt suggests that saw palmetto extracts improve urologic symptoms in patients with benign prostatic hyperplasia.

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