Complementary medicine is often controversial, so it is useful to have this evidence based guide from Professor Ernst and his colleagues at Peninsula Medical School.

The Oxford Handbook evaluates the evidence for a wide range of types of complementary medicine. Each is rated on a six point scale for each relevant medical condition. These range from Beneficial (effectiveness has been demonstrated by clear evidence from Randomised Control Trials, and expectation of harms is small compared with the benefits) to Likely to be ineffective or harmful (for which ineffectiveness or harmfulness has been demonstrated by clear evidence).

The main part of the Handbook consist of an A – Z summary evaluation of each of the main types of complementary medicine, followed by a section on medical conditions (organized by overall type e.g. angina, chronic heart failure and stroke all appear under Cardiology).

The types of complementary medicine for which the Handbook considers there to be the most positive evidence include:

Acupuncture - Beneficial for nausea and vomiting after chemotherapy, surgery or pregnancy related; neck pain; and osteoarthritis of the knee. Likely to be beneficial for seven other conditions, from anxiety to back pain.

Biofeedback (The use of instrumentation to monitor, amplify and feed back information on physiological responses so that a patient can learn to regulate these responses.) - Beneficial for faecal incontinence: bowel control; headache, hypertension, migraine, and urinary stress incontinence: bladder control; Likely to be beneficial for six other conditions, from asthma to Raynauds phenomenon.

Hypnotherapy - Beneficial for labour; Likely to be beneficial for six other conditions, from insomnia to irritable bowel syndrome

Massage - Beneficial for anxiety; Likely to be beneficial for seven other conditions, from depression to back pain.

Music Therapy - Beneficial for anxiety, stress and psychopathology; Likely to be beneficial for three conditions (mood, pain and schizophrenia)

However, Professor Ernst and his colleagues also advise caution with regard to some other types of complementary medicine. In a separate interview he advised, ‘okay, some of these treatments work, but most are not sufficiently researched to be sure, and many are demonstrably ineffective or even dangerous.’

A doctor who ‘road tested’ the Handbook on some patients concluded, ‘It is limited in its content and not without error, but nonetheless….when a patient talks complementary to me, I shall reach for it and see what Ernst and his colleagues have to say, because their quest is evidence-led and when they exist, entries in the handbook are both clear and concise,’

Oxford Handbook of Complementary Medicine - Edzard Ernst, Max H Pittler, Barbare Wider, Kate Boddy (Oxford University Press 2008 ISBN 978-0-19-9206773-3)

Published 13/03/2011