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Use of complementary and alternative medicine is on the rise. Here, we explore the dangers of using an unlicensed practitioner, and find out how you can keep yourself safe.

More of us are looking into natural options for our healthcare, with approximately 38% of adults seeking natural healthcare, either in addition to medical treatment from a doctor (complementary therapy) or instead of medical treatment from a doctor (alternative therapy).

Complementary and Alternative Medicine (CAM) is not one single treatment, but a large body of different possibilities, including: homeopathy (where patients are treated with highly-diluted substances); acupuncture (where pressure points are activated with sterile needles); osteopathy (improving health by manipulating and massaging muscles and joints); chiropractic therapy (concerned with the spinal column), naturopathy (improving health by tackling the whole body: diet, environmental pollution, and possibly providing therapies including colonic hydrotherapy); and herbal medicine (treating the body with herbs and plants).

It all sounds a bit kooky to me.

No doctor will make you see a CAM practitioner, however some of these therapies are recommended by the medical community for a range of conditions.

Acupuncture has been successfully prescribed by the NHS to treat persistent lower-back pain, chronic migraine and tension headaches. It has also been used with some success to treat other musculoskeletal conditions.

Osteopathy is also recommended by NICE (the National Institute for Clinical Excellence, which assesses all treatments in the United Kingdom) for lower-back pain. It also may help recovery following hip or knee surgery, and some other musculoskeletal conditions of the shoulder and neck.

NICE also recommend that spinal manipulation by a chiropractor may be of benefit to some patients with lower-back problems.

Whoopee! I'm going to pick the first chiropractor out of the phone-book and let him get cracking!

Hold on!

While it is tempting, when you're in pain or suffering an illness, to go to the first person who promises relief, that's the last thing you should do. Unlicensed CAM practitioners cause more harm than good.

Let's take a look at some of the risks posed by using an unlicensed natural healthcare practitioner.

Collapsed Lung with Acupuncture

A three-year NHS study examined 325 people who had safety-issues following acupuncture. While most effects were relatively minor (dizziness, temporary loss of consciousness), 1.5% had pneumothorax, a collapsed lung.

A 2010 report by Edzard Ernst found this was most likely to happen with unlicensed acupuncturists, and reported a case where a 26-year-old woman received a pneumothorax, and died as a result. He reported another case, of a woman aged forty-four, who had diabetes and high-blood-pressure, and who also visited an unlicensed acupuncturist, in rural China:

"When an acupuncture needle penetrated her heart, the patient instantly complained of severe and alarming symptoms. Instead of taking urgent action, the acupuncturist inserted a further needle into her chest wall. The patient then died almost immediately. At autopsy, two punctures of the right ventricle were found."

Not only, Ernst's report argues, do many unlicensed acupuncturists have insufficient training to spot problems that may occur, they also think too-highly of the ability of their own interventions to heal all situations. Better training in physiology and life-saving, Ernst argues, is essential.

Even when practiced by qualified and experienced staff, as is always the case in the NHS, research shows there is still a risk of pneumothorax, with five cases - of which one was life-threatening - being reported in UK hospitals in one year. The risk of harm is even higher when performed outside the confines of NHS hospitals.

If you wish to get acupuncture, and - as we've explored - there are times when it may be helpful, see a licensed practitioner. In the UK, there is the British Medical Acupuncture Society, a list of qualified medical professionals who practice acupuncture (a small number of practitioners are available in other countries), or the  British Acupuncture Council. In the US, check the National Certification Commission for Acupuncture and Oriental Medicine [see links].

If you have haemophilia, or are taking anticoagulants (such as Warfarin), you should talk to your doctor before having acupuncture.

Risks of Chiropractic Therapy

Around 50% of patients who have chiropractic therapy have some side effects. Most are mild, including headache or mild aches and pains. However, some people have far more serious side effects.

Serious complications of spinal manipulation include tearing of an arterial wall, leading to a stroke; injury to the spine, leading to paralysis; build up of blood between the skull and the brain, leading to coma and eventual death.

One case of serious problems caused by badly performed chiropractic therapy is of Les Limage. He went to see a chiropractor for neck pain. The manipulation he had caused a stroke and led to him being paralysed and requiring a respirator.

Finally, to the dark and murky side of CAM. Many chiropractic therapists concern themselves with the back and neck (where an untrained person can do enough damage). However, some make a wide range of spurious and unsupportable - if not outright disproved - claims, including that the neck and spinal manipulation they perform can cure cancer. In the UK, chiropractic practitioners are regulated by law (the General Chiropractic Council, see links), and cannot make these kinds of claims. However, Chiropractic practitioners in America are not regulated and may say what they like, including claims to cure cancers "without drugs or surgery".

While Cancer Research UK acknowledges that some patients may find seeing a chiropractor alongside treatment helpful with symptoms such as headaches, feelings of tension and back pain, they are clear on the fact that there is no evidence it prevents, treats or cures any type of cancer

Claims to the contrary are gross charlatanism, the equivalent of the snake-oil salesmen who used to stand on street-corners, selling quack cures: they will do nothing but drain your pocket and leave you beyond the salvation of modern medicine.

Although there is no national licensing system in the USA, many states do have their own licensing body for chiropractors. Make sure your chiropractor is registered.

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