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does it work?
choosing an effective therapy
One of the knottiest problems when using complementary therapies is trying to decide whether a particular condition lends itself to complementary treatment. Even stickier, how do you decide whether that complementary treatment is really likely to be helpful or whether it will be a waste of your time and money? Frankly, there aren't any easy answers to these problems not least because, until fairly recently, most complementary therapies have not been studied using mainstream scientific methods, making it difficult — although not impossible — to evaluate their effectiveness.
Many complementary therapies gain acceptance by virtue of the fact that they have been used for centuries or have gained their reputation by word of mouth among people who have tried them and believe they have been helped. That's not to denigrate opinion and anecdote or to say that they can't be useful: after all, tradition, experience or simply 'hunches' often provide the first inkling that a treatment may be useful, and can provide the impetus for more systematic research.
However with the increasing popularity and use of complementary therapies there have been increasing calls for 'proper evidence'. There is now an admittedly small, but growing, body of research looking at the role certain therapies may have in treating and/or managing particular diseases or conditions.
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finding out more
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To help those who want to learn more about what studies have been done, wherever possible we have provided publication details of research for the conditions on this site. If you want to find out more, just go to each condition and click on journals and other references.
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coding the evidence
In order to help you decide whether a specific therapy or therapies might be useful for you we have used a simple numerical code, based on what evidence is available (see the codes box below). The higher the number the sounder the evidence available. Having said this, the codes aren't meant to be cast in stone or to put you off trying a particular therapy or therapies if you feel they might be helpful to you.
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codes
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5 = DEFINITELY. Good scientific evidence derived from looking at reviews of different studies or by using a meta-analysis, a method of statistically combining the results of a set of different independent studies testing a particular treatment. It consists of looking at all the literature on a particular topic and using this to calculate its probable effectiveness.
4 = PROBABLY. Sound evidence from one or more randomised and/or controlled trials (RCTs).
3 = POSSIBLY. Some evidence from RCTs. However the results are inconclusive, conflicting, or the methods used are questionable.
2 = OPINION. The therapy is widely used for a particular condition and in the opinion and experience of practitioners and/or others is valuable. However there is no reliable research that confirms or refutes this.
1 = RUMOUR. Therapy is traditionally used buts its effectiveness is doubtful or research suggests it may even be ineffective.
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how can therapies be assessed?
In orthodox medicine the 'gold standard' for evidence is what is known as the randomised clinical trial or RCT. These are scientific studies in which two or more forms of treatment are compared. Participants are allocated at random to one of the forms of treatment in order to try and eradicate possible biases in interpreting the results.
This kind of study lends itself better to some interventions that others — notably medications and treatments where it is relatively easy to give a dummy pill or treatment. As yet relatively few RCTs have been carried out on complementary therapies and in any case can be difficult to design and evaluate. However they are now increasingly being done.
Having said this, the lack of RCTs isn't unique to complementary therapies: many widely accepted orthodox treatments — for example some surgical procedures and treatments such physiotherapy and psychotherapy — haven't always been subjected to rigorously conducted scientific evaluation and are used because they always have been or because experience suggests that they work.
When using the codes listed then, it's worth bearing in mind that just because a therapy has a low code it doesn't mean that a condition can't be helped by it. Rather it signifies that that there is a lack of evidence for benefit as opposed to evidence of no benefit.
It's also worth remembering that there is no treatment on earth — orthodox or complementary — that doesn't also involve a host of non-measurable factors such as the interaction between you and the practitioner and the effect that simply receiving treatment has on making you 'feel better'. This so-called placebo effect may play a significant role in aiding healing. (See does CAM work? in the introduction for more about the placebo effect.)
Another point worth making is that many complementary therapies act by helping you to relax. Given that tension and stress can exacerbate symptoms of virtually any illness you care to mention this alone may make a particular therapy worth a try if it particularly appeals to you.
» regulation
(July 2002)
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