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 NCCIH’s mission and role in this area of research.
Complementary Versus Alternative
Many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches developed outside of mainstream Western, or conventional, medicine. 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.”
True alternative medicine is uncommon. Most people who use non-mainstream approaches use them along with conventional treatments.
There are many definitions of “integrative” health care, but all involve bringing conventional and complementary approaches together in a coordinated way. 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.
Integrative Approaches for Pain Management for Military Personnel and Veterans
Chronic pain is a common problem among active-duty military personnel and veterans. NCCIH, the U.S. Department of Veterans Affairs, and other agencies are sponsoring research to see whether integrative approaches can help. For example, NCCIH-funded studies are testing the effects of adding mindfulness meditation, self-hypnosis, or other complementary approaches to pain management programs for veterans. The goal is to help patients feel and function better and reduce their need for pain medicines that can have serious side effects.
Integrative Approaches for Symptom Management in Cancer Patients and Survivors
Cancer treatment centers with integrative health care programs may offer services such as acupuncture and meditation to help manage symptoms and side effects for patients who are receiving conventional cancer treatment. Although research on the potential value of these integrative programs is in its early stages, some studies have had promising results. For example, NCCIH-funded research has suggested that:
- Cancer patients who receive integrative therapies while in the hospital have less pain and anxiety.
- Massage therapy may lead to short-term improvements in pain and mood in patients with advanced cancer.
- Yoga may relieve the persistent fatigue that some women experience after breast cancer treatment.
Integrative Approaches and Health-Related Behaviors
Healthy behaviors, such as eating right, getting enough physical activity, and not smoking, can reduce people’s risks of developing serious diseases. Can integrative approaches promote these types of behaviors? Researchers are working to answer this question. Preliminary research suggests that yoga and meditation-based therapies may help smokers quit, and NCCIH-funded studies are testing whether adding mindfulness-based approaches to weight control programs will help people lose weight more successfully.
So, What Terms Does NCCIH Use?
NCCIH generally uses the term “complementary health approaches” when we discuss practices and products of non-mainstream origin. We use “integrative health” when we talk about incorporating complementary approaches into mainstream health care.
Types of Complementary Health Approaches
Most complementary health approaches fall into one of two subgroups—natural products or mind and body practices.
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. 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.
Mind and Body Practices
Mind and body practices include a large and diverse group of procedures or techniques administered or taught by a trained practitioner or teacher. The 2012 NHIS showed that yoga, chiropractic and osteopathic manipulation, meditation, and massage therapy are among the most popular mind and body practices used by adults. The popularity of yoga has grown dramatically in recent years, with almost twice as many U.S. adults practicing yoga in 2012 as in 2002.
Other mind and body practices include acupuncture, relaxation techniques (such as breathing exercises, guided imagery, and progressive muscle relaxation), tai chi, gi qong, healing touch, hypnotherapy, and movement therapies (such as Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration, and Trager psychophysical integration).
The amount of research on mind and body 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 practices.
Other Complementary Health Approaches
The two broad areas discussed above—natural products and mind and body practices—capture most complementary health approaches. However, some approaches may not neatly fit into either of these groups—for example, the practices of traditional healers, Ayurvedic medicine, traditional Chinese medicine, homeopathy, and naturopathy.
NCCIH is the Federal Government’s lead agency for scientific research on complementary and integrative health approaches.
NCCIH’s Mission and Vision
The mission of NCCIH is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health interventions and their roles in improving health and health care.
NCCIH’s vision is that scientific evidence will inform decisionmaking by the public, by health care professionals, and by health policymakers regarding the use and integration of complementary and integrative health approaches.
To learn more, visit the NCCIH Facts-at-a-Glance and Mission page.
For More Information
NCCIH Strategic Plan
NCCIH’s current strategic plan, Exploring the Science of Complementary and Alternative Medicine: Third Strategic Plan 2011–2015, presents a series of goals and objectives to guide us in determining priorities for future research on complementary health approaches.
The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.