What Is Complementary and 

Alternative Medicine?

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Many Americans use complementary and alternative medicine (CAM) 

in pursuit of health and well-being. The 2007 National Health 

Interview Survey (NHIS), which included a comprehensive survey of 

CAM use by Americans, showed that approximately 38 percent of 

adults use CAM. This fact sheet presents an overview of CAM, types of 

CAM, summary information on safety and regulation, the mission of 

the National Center for Complementary and Alternative Medicine 

(NCCAM), and additional resources.

Defining CAM 

Defining CAM is difficult, because the field is very broad and constantly 

changing. NCCAM defines CAM as a group of diverse medical and health 

care systems, practices, and products that are not generally considered 

part of conventional medicine. Conventional medicine (also called 

Western or allopathic medicine) is medicine as practiced by holders of 

M.D. (medical doctor) and D.O. (doctor of osteopathic medicine) degrees 

and by allied health professionals, such as physical therapists, 

psychologists, and registered nurses. The boundaries between CAM and 

conventional medicine are not absolute, and specific CAM practices may, 

over time, become widely accepted.

“Complementary medicine” refers to use of CAM together with

conventional medicine, such as using acupuncture in addition to 

usual care to help lessen pain. Most use of CAM by Americans is 

complementary. “Alternative medicine” refers to use of CAM in place 

of conventional medicine. “Integrative medicine” combines 

treatments from conventional medicine and CAM for which there is 

some high-quality evidence of safety and effectiveness. It is also 

called integrated medicine.

Types of CAM 

CAM practices are often grouped into broad categories, such as 

natural products, mind and body medicine, and manipulative and 

body-based practices. Although these categories are not formally 

defined, they are useful for discussing CAM practices. Some CAM 

practices may fit into more than one category.
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Natural Products

This area of CAM includes use of a variety of herbal medicines (also known as botanicals), vitamins, 

minerals, and other “natural products.” Many are sold over the counter as dietary supplements. 

(Some uses of dietary supplements—e.g., taking a multivitamin to meet minimum daily nutritional 

requirements or taking calcium to promote bone health—are not thought of as CAM.)

CAM “natural products” also include probiotics—live microorganisms (usually bacteria) that 

are similar to microorganisms normally found in the human digestive tract and that may have 

beneficial effects. Probiotics are available in foods (e.g., yogurts) or as dietary supplements. 

They are not the same thing as prebiotics—nondigestible food ingredients that selectively 

stimulate the growth and/or activity of microorganisms already present in the body.

Historical note: Herbal or botanical medicines reflect some of the first attempts to improve the 

human condition. The personal effects of the mummified prehistoric “ice man” found in the 

Italian Alps in 1991 included medicinal herbs. By the Middle Ages, thousands of botanical 

products had been inventoried for their medicinal effects. 

Current use: Interest in and use of CAM natural products have grown considerably in the 

past few decades. The 2007 NHIS found that 17.7 percent of American adults had used a 

nonvitamin/nonmineral natural product. These products were the most popular form of CAM 

among both adults and children. The most commonly used product among adults was fish 

oil/omega 3s (reported by 37.4 percent of all adults who said they used natural products); popular 

products for children included echinacea (37.2 percent) and fish oil/omega 3s (30.5 percent).

Mind and Body Medicine

Mind and body practices focus on the interactions among the brain, mind, body, and behavior, 

with the intent to use the mind to affect physical functioning and promote health. Many CAM 

practices embody this concept—in different ways.

• Meditation techniques include specific postures, focused attention, or an open attitude 

toward distractions. People use meditation to increase calmness and relaxation, improve 

psychological balance, cope with illness, or enhance overall health and well-being.

• The various styles of yoga used for health purposes typically combine physical postures, 

breathing techniques, and meditation or relaxation. People use yoga as part of a general 

health regimen, and also for a variety of health conditions.

• Acupuncture∗ is a family of procedures involving the stimulation of specific points on the 

body using a variety of techniques, such as penetrating the skin with needles that are then 

manipulated by hand or by electrical stimulation. It is one of the key components of 

traditional Chinese medicine, and is among the oldest healing practices in the world.

 

∗ Acupuncture is considered to be a part of mind and body medicine, but it is also a component of energy medicine, 

manipulative and body-based practices, and traditional Chinese medicine.
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Other examples of mind and body practices include deep-breathing exercises, guided 

imagery, hypnotherapy, progressive relaxation, qi gong, and tai chi.

Historical note: The concept that the mind is important in the treatment of illness is integral 

to the healing approaches of traditional Chinese medicine and Ayurvedic medicine, dating 

back more than 2,000 years. Hippocrates also noted the moral and spiritual aspects of healing 

and believed that treatment could occur only with consideration of attitude, environmental 

influences, and natural remedies.

Current use: Several mind and body approaches ranked among the top 10 CAM practices 

reported by adults in the 2007 NHIS. For example, the survey found that 12.7 percent of adults 

had used deep-breathing exercises, 9.4 percent had practiced meditation, and 6.1 percent had 

practiced yoga; use of these three CAM practices had increased significantly since the previous 

(2002) NHIS. Progressive relaxation and guided imagery were also among the top 10 CAM 

therapies for adults; deep breathing and yoga ranked high among children. Acupuncture had 

been used by 1.4 percent of adults and 0.2 percent of children.

Manipulative and Body-Based Practices 

Manipulative and body-based practices focus primarily on the structures and systems of the 

body, including the bones and joints, soft tissues, and circulatory and lymphatic systems. Two 

commonly used therapies fall within this category:

• Spinal manipulation is practiced by health care professionals such as chiropractors, 

osteopathic physicians, naturopathic physicians, physical therapists, and some medical

doctors. Practitioners perform spinal manipulation by using their hands or a device to 

apply a controlled force to a joint of the spine. The amount of force applied depends on the 

form of manipulation used. The goal of the treatment is to relieve pain and improve 

physical functioning. Spinal manipulation is among the treatment options used by people 

with low-back pain—a very common condition that can be difficult to treat.

• The term massage therapy encompasses many different techniques. In general, therapists 

press, rub, and otherwise manipulate the muscles and other soft tissues of the body. 

People use massage for a variety of health-related purposes, including to relieve pain, 

rehabilitate sports injuries, reduce stress, increase relaxation, address anxiety and 

depression, and aid general well-being.

Historical note: Spinal manipulation has been used since the time of the ancient Greeks and 

was incorporated into chiropractic and osteopathic medicine in the late 19th century. Massage 

therapy dates back thousands of years. References to massage appear in writings from ancient 

China, Japan, India, Arabic nations, Egypt, Greece (Hippocrates defined medicine as “the art of 

rubbing”), and Rome.

Current use: According to the 2007 NHIS, chiropractic/osteopathic manipulation and massage 

ranked in the top 10 CAM therapies among both adults and children. The survey found that 8.6 

percent of adults and 2.8 percent of children had used chiropractic or osteopathic 

manipulation, and 8.3 percent of adults and 1 percent of children had used massage.
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Other CAM Practices

CAM also encompasses movement therapies—a broad range of Eastern and Western 

movement-based approaches used to promote physical, mental, emotional, and spiritual wellbeing. Examples include Feldenkrais method, Alexander technique, Pilates, Rolfing Structural 

Integration, and Trager psychophysical integration. According to the 2007 NHIS, 1.5 percent of 

adults and 0.4 percent of children used movement therapies.

Practices of traditional healers can also be considered a form of CAM. Traditional healers use 

methods based on indigenous theories, beliefs, and experiences handed down from generation

to generation. A familiar example in the United States is the Native American healer/medicine 

man. The 2007 NHIS found that 0.4 percent of adults and 1.1 percent of children had used a 

traditional healer (usage varied for the seven specific types of healers identified in the survey).

Some CAM practices involve manipulation of various energy fields to affect health. Such fields 

may be characterized as veritable (measurable) or putative (yet to be measured). Practices 

based on veritable forms of energy include those involving electromagnetic fields (e.g., magnet 

therapy and light therapy). Practices based on putative energy fields (also called biofields) 

generally reflect the concept that human beings are infused with subtle forms of energy; qi 

gong, Reiki, and healing touch are examples of such practices. The 2007 NHIS found relatively 

low use of putative energy therapies. Only 0.5 percent of adults and 0.2 percent of children had 

used energy healing/Reiki (the survey defined energy healing as the channeling of healing 

energy through the hands of a practitioner into the client’s body).

Finally, whole medical systems, which are complete systems of theory and practice that have 

evolved over time in different cultures and apart from conventional or Western medicine, may 

be considered CAM. Examples of ancient whole medical systems include Ayurvedic medicine

and traditional Chinese medicine. More modern systems that have developed in the past few 

centuries include homeopathy and naturopathy. The 2007 NHIS asked about the use of 

Ayurveda, homeopathy, and naturopathy. Although relatively few respondents said they had 

used Ayurveda or naturopathy, homeopathy ranked 10th in usage among adults (1.8 percent) 

and 5th among children (1.3 percent).
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A Note About Safety and Effectiveness

Rigorous, well-designed clinical trials for many CAM therapies are often lacking; therefore, the 

safety and effectiveness of many CAM therapies are uncertain. NCCAM is sponsoring research 

designed to fill this knowledge gap by building a scientific evidence base about CAM therapies—

whether they are safe; and whether they work for the conditions for which people use them and, 

if so, how they work.

As with any medical treatment, there can be risks with CAM therapies. These general precautions 

can help to minimize risks:

• Select CAM practitioners with care. Find out about the practitioner’s training and experience.

• Be aware that some dietary supplements may interact with medications or other supplements, 

may have side effects of their own, or may contain potentially harmful ingredients not listed 

on the label. Also keep in mind that most supplements have not been tested in pregnant 

women, nursing mothers, or children.

• Tell all your health care providers about any complementary and alternative practices you 

use. Give them a full picture of what you do to manage your health. This will help ensure 

coordinated and safe care. For tips about talking with your health care providers about CAM, 

see NCCAM’s Time to Talk campaign at nccam.nih.gov/timetotalk/. 

NCCAM’s Role 

NCCAM’s mission is to define, through rigorous scientific investigation, the usefulness and safety 

of complementary and alternative medicine interventions and their roles in improving health and 

health care. NCCAM achieves its mission through basic, translational (“bench-to-bedside”), and 

clinical research; research capacity building and training; and education and outreach programs.

Be an Informed Consumer: Information Resources From NCCAM 

The “Health Information” page of the NCCAM Web site (nccam.nih.gov/health/) provides 

access to a variety of information on CAM, as well as links to other National Institutes of 

Health (NIH) resources. Materials include:

• Fact sheets designed to help you think about the issues involved in deciding whether to 

use CAM:

o Are You Considering CAM?

o CAM Use and Children

o Evaluating Web-Based Health Resources

o Paying for CAM Treatment

o Selecting a CAM Practitioner

o Tips for Talking With Your Health Care Providers About CAM

o Using Dietary Supplements Wisely
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• Fact sheets on specific CAM therapies (e.g., Yoga for Health: An Introduction) and on CAM for 

specific health conditions (e.g., CAM and Hepatitis C: A Focus on Herbal Supplements)—

including information on safety, the status of evidence-based research on effectiveness, 

and points to consider in deciding to use the therapy.

• Herbs at a Glance: Information on more than 40 of the most common herbs in popular 

dietary supplements. Available in a booklet and in individual fact sheets.

A Note About Government Regulation

Dietary Supplements

The Federal Government regulates dietary supplements primarily through the U.S. Food and 

Drug Administration (FDA). The regulations for dietary supplements are not the same as those 

for prescription or over-the-counter drugs. In general, the regulations for dietary supplements 

are less strict; for example, a manufacturer does not have to prove the safety and effectiveness 

of a dietary supplement before it is marketed. Once a dietary supplement is on the market, the 

FDA monitors safety and product information (label claims and package inserts), and the 

Federal Trade Commission (FTC) monitors advertising.

Practitioner-Based Therapies

There is no standardized, national system for credentialing CAM practitioners. The extent and 

type of credentialing vary widely from state to state and from one CAM profession to another. 

For example, some CAM professions (e.g., chiropractic) are licensed in all or most states, 

although specific requirements for training, testing, and continuing education vary; other CAM 

professions are licensed in only a few states or not at all.

For More Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on CAM and NCCAM, 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. 

Toll-free in the U.S.: 1-888-644-6226

TTY (for deaf and hard-of-hearing callers): 1-866-464-3615

Web site: nccam.nih.gov

E-mail: info@nccam.nih.gov
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Office of Dietary Supplements (ODS)

ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating 

scientific information, supporting research, sharing research results, and educating the public. 

Its resources include publications (such as Dietary Supplements: What You Need to Know), facts 

sheets on a variety of specific supplement ingredients (such as vitamin D and black cohosh), 

and the PubMed Dietary Supplement Subset.

Web site: ods.od.nih.gov

E-mail: ods@nih.gov

U.S. Food and Drug Administration (FDA)

Center for Food Safety and Applied Nutrition

Web site: www.fda.gov/AboutFDA/CentersOffices/OfficeofFoods/CFSAN/

Toll-free in the U.S.: 1-888-723-3366

Information includes Tips for the Savvy Supplement User: Making Informed Decisions and Evaluating 

Information (www.fda.gov/food/dietarysupplements/consumerinformation/ucm110567.htm) and 

updated safety information on supplements (www.fda.gov/Food/DietarySupplements/Alerts). If 

you have experienced an adverse effect from a supplement, you can report it to the FDA’s 

MedWatch program, which collects and monitors such information (1-800-332-1088 or 

www.fda.gov/Safety/MedWatch).

PubMed®

A service of the National Library of Medicine (NLM), PubMed contains publication information 

and (in most cases) brief summaries of articles from scientific and medical journals.

Web site: www.ncbi.nlm.nih.gov/sites/entrez

NIH National Library of Medicine’s MedlinePlus

To provide resources that help answer health questions, MedlinePlus brings together 

authoritative information from the National Institutes of Health as well as other Government 

agencies and health-related organizations.

Web site: www.medlineplus.gov
This publication is not copyrighted and is in the public domain.

Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the 

medical expertise and advice of your primary health care provider. We encourage you to 

discuss any decisions about treatment or care with your health care provider. The mention of 

any product, service, or therapy is not an endorsement by NCCAM.

National Institutes of Health 

♦♦♦

U.S. Department of Health and Human Services

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Created October 2008

Updated May 2012