People with a brain injury encounter modern medicine from the moment the ambulance arrives or they get to an emergency room. Modern or “mainstream” medicine has evolved using strict scientific methods of evidence and rigorous demands for proof of efficacy (does it work?) and safety. Years of research and millions of dollars are spent to prove medical therapies safe and effective before they are approved for use outside clinical trials.
This process is slow, but it doesn’t stop. The medical community is desperate for faster, more effective treatments that have fewer side effects. Drug companies know that if they don’t continue to push the boundaries of their own knowledge, they will quickly be swamped in a highly competitive marketplace by companies that do. Practitioners know that sometimes the right medication or treatment doesn’t exist yet, and will carefully trial alternatives until the most effective, safest treatment plan can be found.
Unfortunately, the limitations of knowledge and the costs of developing, proving, marketing and distributing medications means that many people either can’t afford the treatment they desperately need, or can’t find a treatment that is effective for them. This can see them turn to alternative treatments in search of a solution and a better quality of life. Due to lack of medical knowledge, a feeling of desperation, and the hope that alternatives suggest, many families become vulnerable consumers.
Alternative medical practices are those philosophies, therapies, and medications that have not passed the standards of modern medicine. Frequently based in the philosophies, religion and medicines of traditional cultures, they have often not been studied or show only minor benefit and have not been judged worthwhile by mainstream medicine. Complementary medicine practices are mainstream medical practices which are used for purposes other than what they were proven or intended for.
Many treatments were once alternative and have become mainstream – putting mouldy bread on wounds was once just a housewife’s remedy until the antibiotic penicillin was identified, cultured, and produced in a pure form. Vitamins were found to cure scurvy and other previously unexplained illnesses, and the acidophilus cultures commonly put into supermarket yoghurt are now recognised as a major component of the heath of your intestines. The important point to note is that therapies which are still alternative are alternative because they have not succeeded in becoming mainstream, not just because they come from a non-mainstream culture. They may struggle to convince doctors who are right to be cautious about claims that seem to be miraculous, or they may simply not do what they claim to do.
There are also treatments or therapies that are effective ways to promote health even if all the claims made for their effectiveness can be questioned. Tai Chi (also spelt Dai Qi) is a very effective way to improve balance, coordination, strength, flexibility and cardio-vascular fitness. It becomes an alternative therapy when people claim that it can also cure illness, a claim that has not been reliably supported beyond the benefits of having a stronger, healthier body.
Research may not have been done because of insufficient research money, a small group of patients that would benefit, lack of people who know how to provide the therapy, or the fact that the intervention makes no scientific sense to practitioners. The research may also be lacking because the therapy is brand new and there simply has not been time to accumulate reasonable evidence. In that situation, it is doubly important to assess the potential risks of the therapy.
Alternative and complementary medicines are alternative and complementary because they lack unbiased, controlled research studies that prove them effective. More importantly, they may also lack unbiased, controlled research studies that prove them safe.
Another risk factor is that alternative medicines are not regulated by the same legislative controls that mainstream medications must go through. There may also not be minimum standards of qualification for the practitioners. This can result in a physical therapy doing more harm than good, or it can result in a potentially severe reaction to an herbal treatment, or the treatment not having any effect at all despite the fact that a rival brand may have a small effect because it is made slightly differently.
The World Health Organisation reports that although 25% of modern medicines are made from plants first used traditionally, there have been many instances of deaths, heart attacks, strokes or other severe internal organ damage due to overdosing on herbal medications or an incorrect species of plant being used to make the medication.
Many alternative medicines also interact quite badly with prescription medicines. A good example of this is
Today many people use alternative medicine for a wide variety of disorders. Medical science is still learning much about how drugs work upon the body, and about herbal and other alternative therapies. Many of these therapies may be of value without having been adequately or appropriately researched yet. It is important, however, that anybody considering an alternative therapy, or an uncommon application of a mainstream therapy, be informed about the risks and the possible costs if it doesn’t work.
One method used to help evaluate alternative medical interventions is called Evidence Based Medicine. This approach asks four questions about the data supporting each medicine practice, procedure, or therapy to help decide if they are worth trying. The following list is taken from the Brain Injury Resource Foundation:
If a therapy or medicine does not meet any of these criteria, then ask whether the potential benefit of this treatment is enough to justify the time, money, emotional investment and potential medical complications that could occur.
You should also look more closely at a therapy if there is a lot of controversy attached to it. Claims that there is a conspiracy to discredit a practitioner or their preferred therapy should not be trusted. Lots of individual people can be wrong, but science works and medicine progresses because the majority of trained, dedicated experts usually get it right, and will discredit a therapy because it has no effect more often than they will discredit a therapy that has not been given an opportunity to prove itself.
Claims of a miraculous cure should also be distrusted. Seemingly miraculous cures are possible, but usually take enormous amounts of time, effort or money.
Some interventions do have an effect and are medically safe but may be poor value or money or extremely time-intensive. Families may opt to pursue these if they have the time and money. Families need to consider the effect on their future security, other family members, and their emotional feelings if the results are not what they hoped for.
On the other hand, it is very difficult for science to evaluate quality of life. Even when there is a limited medical benefit from a therapy there may be a very real benefit to the patient from the sense of purpose, satisfaction, or hope that the treatment can provide.
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