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 the mission and role of the National Center for Complementary and Integrative Health (NCCIH) in this area of research. The terms “complementary,” “alternative,” and “integrative” are continually evolving, along with the field, but the descriptions of these terms below are how we at NIH currently define them.
Complementary Versus Alternative
According to a 2012 national survey, many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice. 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.”
Most people who use non-mainstream approaches also use conventional health care.
In additional to complementary and alternative, you may also hear the term “functional medicine.” This term sometimes refers to a concept similar to integrative health (described below), but it may also refer to an approach that more closely resembles naturopathy (a medical system that has evolved from a combination of traditional practices and health care approaches popular in Europe during the 19th century).
Integrative health care often brings conventional and complementary approaches together in a coordinated way. It emphasizes a holistic, patient-focused approach to health care and wellness—often including mental, emotional, functional, spiritual, social, and community aspects—and treating the whole person rather than, for example, one organ system. It aims for well-coordinated care between different providers and institutions.
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:
- An NCCIH-funded study is developing an innovative, collaborative treatment model involving chiropractors, primary care providers, and mental health providers for veterans with spine pain and related mental health conditions.
- Other 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.
- For more information on pain management for military personnel and veterans, see NCCIH’s Complementary Health Practices for U.S. Military, Veterans, and Families webpage.
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:
- 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, according to the results of a preliminary study.
- Tai chi or qi gong have shown promise for managing symptoms such as fatigue, sleep difficulty, and depression in cancer survivors.
- For more information, see NCCIH’s fact sheet on cancer.
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. Research is looking at whether complementary and integrative approaches may have a role in promoting healthy behaviors. For example:
- Preliminary research suggests that yoga and meditation-based therapies may help smokers quit.
- In a study funded by the National Cancer Institute, complementary health practitioners (chiropractors, acupuncturists, and massage therapists) were successfully trained to provide evidence-based smoking cessation interventions to their patients.
- An NCCIH-funded study is testing whether a mindfulness-based program that involves the whole family can improve weight loss and eating behavior in overweight adolescents.
- For more information, see the NCCIH Quitting Smoking and Weight Control webpages.
Types of Complementary Health Approaches
Complementary health approaches include natural products and 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 for the conditions studied. 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, and meditation are among the most popular mind and body practices used by adults. According to the 2017 NHIS, the popularity of yoga has grown dramatically in recent years, from 9.5 percent of U.S. adults practicing yoga in 2012 to 14.3 percent in 2017. The 2017 NHIS also showed that the use of meditation increased more than threefold from 4.1 percent in 2012 to 14.2 percent in 2017.
Other mind and body practices include acupuncture, relaxation techniques (such as breathing exercises, guided imagery, and progressive muscle relaxation), tai chi, qi gong, hypnotherapy, 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
Some complementary approaches may not neatly fit into either of these groups—for example, the practices of traditional healers, Ayurvedic medicine, traditional Chinese medicine, homeopathy, naturopathy, and functional medicine.
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 informs decision making 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 webpage.