Best Alternative Medicine. What works? What does not?, The

Neurology Report, Jun 2001

The Best Alternative Medicine. What works? What does not? Pelletier KP. New York, NY: Simon & Schuster; 2000, hardcover, 449pp, ISBN: 0-684-84207-6, $26.00.

Dr. Kenneth Pelletier, director of the Complementary and Alternative Medicine Program at Stanford (CAMPs), has written a reference text for persons who are considering the use of complementary or alternative medicine (CAM) but are skeptical about the extreme and unsubstantiated claims made by many practitioners and companies. What makes this book different from many other books on this topic is that the author does not promote a particular system of medicine nor does he provide anecdote after anecdote about people who have been significantly helped or cured by their use of CAM. Rather, Pelletier offers a well-researched text in which the reader is able to obtain general background information on a wide range of complementary medicine approaches and alternative medical systems. Specific information regarding research findings that either support or refute the use of CAM in certain conditions also is included.

Part I of the book, "Major Areas of Treatment," is divided into 13 chapters that range in topics from homeopathy and acupuncture to insurance coverage and the concept of integrative medicine. In the first chapter of part I, the author provides a historical and global perspective to the growing interest in CAM and explains how he compiled and assessed the research that is cited in the book. Further discussion includes advice to the reader regarding the information required to make an informed decision about what procedures, interventions, or approaches to use or not use.

Subsequent chapters in part I review specific CAM interventions including mind-body medicine, dietary and herbal supplements,Traditional Chinese Medicine and acupuncture, naturopathic and chiropractic medicine, homeopathy, spirituality, and Ayurvedic medicine. Most chapters are organized into background information, general principles, definitions, and descriptions of specific interventions. Review of the experimental work that has been done in a particular area of CAM is organized into sections called "what works," "what does not work," and "what's in the works." The strength, but also the most significant limitation, of the book lies within these sections. Here the author cites peer-reviewed scientific literature and summarizes the results in a manner that is very practical and easy to understand. The limitation is that the reader does not have immediate access to the primary source of the information and therefore, must rely on the author's critique of the study and interpretation of the findings. Studies with results that support the approach or intervention are included in "what works" whereas studies with results that do not support the technique are included in "what doesn't work." The author also provides information regarding funded projects that are currently being conducted.

Part II of the book is titled "CAM Therapies for Specific Conditions." This section can be useful to both patient and health care provider because it allows the reader to look up a specific problem such as arthritis, carpal tunnel syndrome, or osteoporosis. For each condition, a summary of CAM techniques that may be considered helpful is provided. Each technique or intervention identified in this section has been described in previous chapters with pertinent scientific studies documented and reviewed.

The book also includes a section called,"Selected Bibliography." This reference list is organized according to the chapters in the book, which allows the reader to identify many primary sources of data or information as it pertains to a particular CAM approach.

This text should prove to be helpful to physical therapists interested in exploring CAM for or with their patients. Several of the conditions outlined in the book such as tendonitis, pain, and sciatica are issues for many physical therapy patients. Physical therapists who manage patients with neurological conditions will find that diagnoses such as vertigo, Parkinson's disease, dementia, and epilepsy are also included in the text. This book allows the therapist to quickly review CAM considerations for many concerns pertinent to patients receiving physical therapy. From this quick review, the therapist can read about the CAM approaches in preceding chapters, or seek out the primary sources to assess whether an intervention should be considered given the specifics of the particular patient. Although, not specifically written for health care providers, this text provides an excellent starting point for therapists who are interested in exploring the use CAM in a patient population.