You Use That Stuff, Too?

Chiropractic

Some mainstream doctors may view it as a fringe treatment, but chiropractic is more commonly covered by insurance than any other type of alternative care. About 95 percent of PPOs and 80 percent of HMOs provide some coverage for chiropractic care, according to the American Chiropractic Association. An estimated 30 million Americans visit chiropractors each year -- mostly for low back pain. In the NCCAM survey, 7 percent of respondents reported receiving chiropractic care in past 12 months; 20 percent reported ever having gone to a chiropractor.

Do the treatments help? Depends on whom you ask.

A Cochrane Collaboration meta-analysis published last year in the Annals of Internal Medicine suggested that spinal manipulative therapy worked better than sham manipulation and discredited therapies at relieving acute or chronic low-back pain. But researchers found no evidence spinal manipulation was better than other standard treatments.

William Meeker, director of the Palmer Center for Chiropractic Research in Davenport, Iowa, which has received NCCAM funding, said researchers don't yet fully understand the exact biomechanism by which spinal adjustments might relieve pain. One theory, he said, is that bombardment of impulses to the sensory system modifies pain sensation; another is that spinal manipulation changes the way joint surfaces interact with each other.

Side effects of chiropractic treatment, Meeker said, can include muscle soreness and pain. One maneuver to the upper cervical spine has been implicated in strokes, but the incidence is very rare, he said.

Yoga

The ancient practice that combines deep breathing, meditation and stretching has become wildly popular in the past several years. According to a 2003 survey by Yoga Journal magazine, 15 million people -- mostly women -- practice yoga in the United States. Among respondents to the NCCAM survey, 5 percent had tried it within the last year.

Most Americans practice yoga for fitness and stress reduction, but Mary Lou Gallantino, a physical therapist who researches yoga at the University of Pennsylvania Medical School, said more people are turning to yoga as therapy. Some of the most common ailments that she said send people to their yoga mats: depression, anxiety, hypertension, asthma and back pain.

A study published this month in the journal Neurology found that people with multiple sclerosis who practiced yoga for six months significantly reduced fatigue levels.

Other studies have found that yoga may help with chronic low back pain, sleep problems and hypertension. Harvard researcher Sat Bir Singh Khalsa has found yoga reduces the levels of stress hormones in some people, allowing them to fall asleep more easily even after they discontinue yoga exercises.

"It's a very good treatment for stress-related disorders," Khalsa said. Gallantino said she used yoga to help her through her recent battle with breast cancer. "It assisted with the side effects of chemotherapy for me. I was fully functional, and I didn't have any major energy loss," she said. "I was able to weather the storm."

Some people do injure themselves while trying to contort themselves into yoga positions, and bikram, or "hot," yoga is not recommended for people with heart conditions or who have had previous problems with heat cramps or heatstroke.