Understanding Complementary Medicine

Definition of Complementary Medicine

Complementary (adj)– forming a complete or balanced whole

Medicine – the scientific study or practice of diagnosing, treating, and preventing disease or disorders of the body or mind of a person or animal     

Definition of complementary medicine (modified) from the Cochrane Collaboration1

Complementary medicine (CM) is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CM and between the CM domain and that of the dominant system are not always sharp or fixed.

We use the term complementary medicine to describe healthcare practices such as those listed. We use it synonymously with the terms "complementary therapies" and "complementary and alternative medicine" found in other texts, according to the definition used by the Cochrane Collaboration.

Common complementary therapies

* Acupressure  * Chiropractic  * Naturopathy  * Acupuncture  * Osteopathy  

* Cranial osteopathy  * Nutritional therapy  * Alexander technique  

* Environmental medicine  * Reflexology  * Applied kinesiology  * Healing  

* Reiki  * Anthroposophic medicine  * Herbal medicine  

* Relaxation and visualisation  * Aromatherapy  * Homoeopathy  

* Autogenic training  * Hypnosis  * Shiatsu  * Ayurveda  

* Massage  * Therapeutic touch  * Meditation  * Yoga

The Therapeutic Goods Administration definition of complementary medicines2

In Australia, medicinal products containing such ingredients as herbs, vitamins, minerals, nutritional supplements, homoeopathic and certain aromatherapy preparations are referred to as 'complementary medicines' and are regulated as medicines under the Therapeutic Goods Act 1989 (opens in a new window) (the Act).  

Definition of complementary medicine from the World Health Organisation (WHO) 3

Traditional medicine (TM):
Traditional medicine has a long history. It is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. (http://www.who.int/medicines/areas/traditional/definitions/en/).
Complementary medicine (CM):
The terms "complementary medicine" or "alternative medicine" refer to a broad set of health care practices that are not part of that country's own tradition or conventional medicine and are not fully integrated into the dominant health-care system. They are used interchangeably with traditional medicine in some countries. (http://www.who.int/medicines/areas/traditional/definitions/en/).
Traditional and complementary medicine (T&CM):
T&CM merges the the terms TM and CM, encompassing products, practices and practitioners.

The Four CM Domains

1. Mind-Body Medicine

Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to affect bodily function and symptoms. These include meditation and therapies that use creative outlets such as art, music, or dance.

2. Biologically-based Practices

Biologically based practices in CM use substances found in nature, such as herbs, foods, and vitamins. This includes what the Australian Therapeutic Goods Administration defines and regulates as Complementary Medicines. Some examples include dietary supplements and herbal medicines.

3. Manipulative and Body-based Practices

Manipulative and body-based practices in CM are based on tactile therapies and structured exercise regimes. Manipulation involves the application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. Manipulation may be performed as a part of other therapies or whole medical systems, including chiropractic medicine, osteopathic medicine, massage and naturopathic medicine. Structured exercise regimes include yoga, tai chi and specific exercise programs aimed at restoring health and enhancing well being.

4. Energy Medicine

Energy therapies involve the use of energy fields. They are of two types: biofield therapies and bioelectromagnetic based therapies.

Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy purportedly manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields. Examples include:

  • Qi gong, a component of traditional Chinese medicine that combines movement, meditation, and controlled breathing. The intent is to improve blood flow and the flow of qi.
  • Reiki, a therapy in which practitioners seek to transmit a universal energy to a person, either from a distance or by placing their hands on or near that person. The intent is to heal the spirit and thus the body.
  • Therapeutic Touch is a therapy in which practitioners pass their hands over another person's body with the intent to use their own perceived healing energy to identify energy imbalances and promote health.

Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating-current or direct-current fields. 

Whole Medical Systems

Whole medical systems can cut across all domains. Whole medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart fro, and earlier than, the conventional medical approach. Examples of whole medical systems that have developed in Western cultures include homeopathic medicine and naturopathic medicine. 

  • Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called "like cures like").
  • Naturopathy aims to support the body's ability to heal itself through the use of dietary and lifestyle changes together with CM therapies such as herbs, massage, and joint manipulation.

Examples of systems that have developed in non-Western cultures include traditional Chinese medicine (TCM) and Ayurvedic medicine. 

  • TCM is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbal treatments, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi.
  • Ayurveda is a whole medical system that originated in India. It aims to integrate the body, mind, and spirit to prevent and treat disease. Therapies used include herbs, massage, and yoga.

Facts and Statistics

Complementary medicines have a long history of use. Some 2,500 years ago, the Chinese were using treatments made of mouldy soybean curd to treat infections. Only in 1942 did Howard Florey and Ernst Chain develop the manufacturing process for penicillin, enabling the first antibiotics to be sold as drugs.

Many modern pharmaceuticals are derived from plants used in complementary medicine.  Common examples include aspirin (from willow bark), the cardiac drug digoxin (from foxglove), quinine (from cinchona bark) and ephedrine (from ma huang, a widely used Chinese medicine).

At least two out of three Australians use some form of complementary medicine4 , with rates as high as 87% among specific patient groups, such as those with breast cancer5.  

Australians invest heavily in complementary medicines, spending over $3.5 billion each year on complementary medicines and therapies 6

Consumers use them as part of their self-care approach and seek better information to support their healthcare choices7

Australians spent $2 billion in out of pocket expenses on complementary medicines in 2010–11. This is more than the out of pocket contribution to pharmaceuticals of $1.6 billion8

Evidence has shown many complementary medicines to have excellent safety and efficacy profiles, providing advantages over available treatment, and offering treatment options where none currently exists.
Example include:

* Acupuncture for relief of chronic lower back pain and depression9  
* Omega 3 fatty acids to prevent secondary cardiovascular events in Australia10 
* Calcium and vitamin D supplementation to reduce the incidence and severity of osteoporosis11 
* St John's wort for mild to moderate depression12 

Complementary medicines represent a substantial,  growing industry  with manufacturing jobs and export potential in Asia.  Industry revenue is currently $3.5 billion and is expected to grow to $4.6 billion in 2017–1813. Over this period, employment is anticipated to rise to 45,00014

Australian companies export around $200m in complementary medicines to more than 20 countries in Southeast Asia, Europe and the Americas and this continues to grow at higher rates than domestic consumption. There is enormous growth potential for the export market15

Australian Government support for complementary medicine research  is minimal.  NHMRC funding for complementary medicine has been 0.2% of total funding from 2003-2012, despite high levels of usage by the Australian public and despite being acknowledged as a major health issue in successive NHMRC Strategic Plans. In 2012, funding for complementary medicines fell to 0.14% of total funding or $1.24m out of a total of $780m.


1. Zollman C, Vickers A. What is complementary medicine? BMJ. 1999;319(7211):693-6. DOI: 10.1136/bmj.319.7211.693.

2. Therapeutic Goods Administration. An overview of the regulation of complementary medicines in Australia. Available from: http://www.tga.gov.au/industry/cm-basics-regulation-overview.htm

3. World Health Organisation (WHO). WHO traditional medicine strategy: 2014-2023. Geneva, Switzerland 2013. Available from  http://apps.who.int/iris/bitstream/10665/92455/1/9789241506090_eng.pdf

4. National Prescribing Service. National Consumer Survey 2006: final report. Sydney: National Prescribing Service, 2006.

5. Kremser T, Evans A, Moore A, Luxford K, Begbie S, Bensoussan A, et al. Use of complementary therapies by Australian women with breast cancer. Breast. 2008;17(4):387-94. DOI: 10.1016/j. breast.2007.12.006.

6. Access Economics. Cost effectiveness of complementary medicines, Report to the National Institute of Complementary Medicine, Sydney, Australia. 2010.

7. National Prescribing Service, Information Use and Needs of Complementary Medicines Users, December 2008.

8. Australia Institute of Health and Welfare. Health expenditure Australia 2010-2011. (Health and welfare expenditure series no. 47. Cat. no. HWE 56). 2012.

9. Vickers AJ, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012; 172(19):1444-1453. Published online September 10, 2012. doi:10.1001/archinternmed.2012.3654.

10. Access Economics. Cost effectiveness of complementary medicines, Report to the National Institute of Complementary Medicine, Sydney, Australia. 2010.

10. Tang BMP, et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. The Lancet. 2007; 370(9588): 657-666.

12. Morgan AJ, Jorm AF. Self-help interventions for depressive disorders and depressive symptoms: a systematic review. Ann Gen Psychiatry. 2008; 7:13.

13. IBIS World, Alternative Health Therapies in Australia, August 2012.

14. IBIS World, Alternative Health Therapies in Australia, August 2012.

15. CHC Industry Audit May 2011.