A conventional prescription will get you better when you’re sick. But other modalities seek to go way beyond the quick fix of pills.
Integrative medicine is a field that uses the techniques of conventional medicine in coordination with scientifically supported modalities of complementary and alternative medicine (CAM).
Integrative medicine rests on the belief that the body has an innate ability to heal itself and that the best approaches are the most natural and least invasive.
Practitioners focus on the “whole person”—including social, emotional, physical, mental and spiritual well-being—to get at the underlying cause of an illness rather than just treating the physical manifestations of disease. “Western medicine is very good at what it does which is diagnosing disease,” says Dr. Seth Torregiani, who practices osteopathic medicine, acupuncture and integrative medicine in North Wilmington. “But if you have chronic neck tension or fibromyalgia, Western medicine doesn’t have as much to offer.”
More than a third of adults use some form of CAM, according to the National Center for Complementary and Integrative Health. The typical patient is female, middle-aged, well-educated and relatively affluent. “I think sometimes the medical system doesn’t listen well to women when they have chronic pain,” says Torregiani. “A lot of time the explanation is because they’re stressed out or depressed or it’s all in their head.”
Complementary and alternative therapies fall into three general categories: mind-body medicine, whole medical systems and biologically based practices.
Chiropractic is the largest, most regulated and best recognized of the professions that lie outside the realm of conventional medicine. Chiropractic has taken on many of the characteristics of an established profession: improving its educational and licensing requirements and increasing its market share.
The public increasingly relies on chiropractic for treatment of chronic pain and appears satisfied with the results. According to a recent Gallup survey, about 63 million Americans visited a chiropractor in the last five years and most were pleased with the results. Many times their visits were the result of referrals from other healthcare professionals.
Moreover, of all the alternative care professions, chiropractic has gained the most acceptance from private and public insurance systems.
Chiropractors are turning up more and more often on interdisciplinary teams where they work alongside other healthcare professionals in a variety of settings.
Still, chiropractic remains firmly rooted in alternative medicine. It retains its own unique philosophy of care and the central role of the spinal adjustment in its treatment plan. Chiropractic is not taught in medical or nursing schools and practitioners do not perform surgery or prescribe pharmaceuticals.
Chiropractic rests on the notion that minor slippages of the vertebrae—called subluxations—pinch spinal nerves leading to a variety of diseases. “The chiropractor’s job is to adjust the primary condition and in most people the primary condition is an abnormal spinal structure,” says Dr. Chad Laurence of Corrective Chiropractic in Hockessin.
Photo by Luigi Ciuffetelli
Dr. Chad Laurence of Corrective Chiropractic
While there are many forms of spinal manipulations, the technique most associated with chiropractors is known as the “dynamic thrust,” a low-speed, high-force pressure applied to a joint between two vertebrae. Additionally, there are high-speed low-force techniques that are safer and less painful than those employing dynamic thrust manipulations.
Practitioners also use electronic stimulation, ultra-sound or traction devices that stretch the spine, decompress the discs and reduce the pressure on the nerve roots to treat pain.
Laurence takes X-rays of new patients both to screen for serious conditions and to demonstrate progress throughout treatment. “When you go to an orthodontist you expect to see straighter teeth,” he says. “My patients expect to see evidence of change on their spinal films.”
Back pain remains one of the primary reasons people visit chiropractors. Three decades of studies and research indicate that spinal manipulation is effective in the treatment of low back pain—particularly chronic pain—neck pain, muscle tension headaches and a host of other conditions.
Laurence says he’s had success in the management of sinus problems, middle ear infections as well as allergies and asthma, especially in those cases where the breathing apparatus has been compromised by poor posture.
Chiropractic is contraindicated for serious conditions of the bone, spinal cord or bone marrow as well as rheumatoid arthritis, but for the most part, treatments are safe and complications rare. Laurence maintains that even individuals with osteoporosis can benefit from gentler manipulations that keep muscles flexible. “It’s rare that I get a condition where I can’t work on somebody,” he says.
The modern chiropractor has become an excellent resource for restoring and maintaining health. Chiropractic care now includes recommending lifestyle changes, including home-based exercises as well as ergonomic and postural adjustments. “Education is a large part of my practice,” says Laurence.
Laurence says he enjoys a good working relationship with other healthcare professionals and that many of his patients are referrals. “I get referrals from medical doctors for patients with musculoskeletal conditions, from physical therapists and from dentists for patients with TMJ,” he says. “And I refer to doctors who respect my profession.”
Laurence says some of his new patients express concern that once they’ve visited a chiropractor they will have to continue for the rest of their lives. “I go to the dentist twice a year and I’m 42 years old. For my patients who decide to come once or twice a month, they want to sustain the work they’ve done. They want to feel good. It’s good to feel good.”
As with chiropractic, more and more people have come to recognize the health benefits of massage. According to a 2015 American Massage Therapy Association survey, almost a quarter of all adult Americans reported receiving a massage from a professional massage therapist in the past year. Additionally, 54 percent of respondents indicated they were encouraged by their doctor to receive a massage, up from 48 percent just two years earlier.
A growing body of research does indeed confirm the therapeutic benefits of massage. Regular massage can ease back pain, boost the immune system, reduce the frequency of migraine headaches, relieve anxiety and reduce depression. Traditional massages—like Swedish—are great for relaxation. But more dedicated techniques are needed to treat specific ailments. Deep tissue massage is ideal for “trouble spots” in the body because it focuses on the soft tissues deep beneath the skin.
Like deep tissue, trigger point massage concentrates on specific areas within muscles—called trigger points—that can cause pain in other parts of the body. Neuromuscular is a special form of trigger point massage that addresses chronic pain involving muscular and nervous systems, including problems causes by repetitive motion injuries.
Many therapists use more than one style per session to customize the massage to fit the client’s special needs or goals. “No two sessions are ever the same because the client’s issues may have changed since their last session,” says Terry Meyer, owner of Massage & Reflexology of Delaware in Wilmington. “It’s not a one-size-fits-all kind of thing.”
Despite its reported health benefits, massage is contraindicated in certain situations. People on blood thinners should avoid deep pressure therapies. Individuals who have just undergone surgery or who are undergoing chemotherapy and radiation for cancer should check with their physician before scheduling a massage. Multiple sclerosis patients should also avoid massage if they’re relapsing.
Massage can also be risky for those with severe osteoporosis or cancers of the lymphatic system. Most techniques can be performed on diabetics as long as their condition is stable and their skin intact. However, because of the possibility of neuropathy, it is advisable to avoid deep tissue techniques. In addition, some informal studies have shown that full body massage can lower blood sugar levels 20 to 30 points, resulting in a hypoglycemic episode.
Meyer also will not perform massage on a woman in her first trimester of pregnancy. “That first trimester is most important and you don’t want any stress,” she says.
Meyer recommends that clients stay on some sort of regular schedule with massage. “One massage just like one antibiotic is not going to take care of your problem.”
Despite popular misconception, reflexology is technically not a form of massage. Rather, reflexology is a separate form of bodywork that focuses on the feet and hands. It rests on the notion that there are “reflex” areas on the hands and feet that are connected to other parts of the body. For example, the tips of the toes correspond to the head; the heart and chest to the ball of the foot; the liver, pancreas and kidney to the arch of the foot.
Reflexologists use “maps” to demonstrate how the body systems relate to each other, which is why Meyer, who also practices reflexology, refers to it as geographical. And while there may not be agreement among practitioners on all points, there is general agreement on major reflex points.
Practitioners believe that by applying pressure to these areas they can promote health in the corresponding organs through energy pathways. Unlike massage, reflexology does not attempt to manipulate soft tissue.
Reflexology seems to be effective in reducing pain. Researchers at the University of Portsmouth found that participants receiving reflexology not only experienced a decrease in pain but also could tolerate pain for a longer period of time.
Meyer says reflexology is an ideal therapy for people whose medical conditions do not permit them to be touched or for those uncomfortable with touch, including victims of sexual assault. “It’s very versatile,” she says. “You can’t box it into one area.”
Like reflexology, acupuncture seeks to stimulate the body’s self-healing process by restoring the flow of energy or chi through pathways called meridians. Practitioners accomplish this by inserting thin solid needles into the skin at certain points on the body. The depth of insertion depends on the ailment being treated and the anatomy. Pressure, heat or electrical stimulation may also be applied to enhance the effects.
There is no anatomical or scientific proof to support the Chinese medical theory regarding energy flows. However, research has shown that acupuncture needling stimulates the activity of adenosine, an amino acid that becomes active in the skin after an injury to ease pain.
Because it addresses the whole body, acupuncture treats conditions ranging from musculoskeletal problems to nausea (both from pregnancy and cancer treatments), migraine headaches, anxiety, depression and insomnia. “I like to say I treat everything except emergency medicine,” says Denise Demback, co-owner of Active Life Acupuncture in Milton.
It can be especially effective in treating women’s issues such as infertility and menstrual discomfort. “I’ve had people say they had cramps so bad they’d drop to the floor,” says Demback. “But after a couple of treatments, the cramps are gone.”
It can also be useful in treating neurological conditions like Parkinson’s disease. “Acupuncture seems to reduce the muscle spasms and tremor associated with Parkinson’s,” says Demback.
Acupuncture is a relatively safe form of treatment, the major complications being some slight bruising at the acupoint or a broken capillary. Demback says even people who are afraid of needles are surprised by the overall sense of well-being they feel after treatment. “People are amazed at how relaxed they are,” says Demback. “They say they’ve gotten the best night’s sleep ever.”
Dr. James Frisa, an acupuncturist in Dover, is also a certified Esogetic Colorpuncture Light Therapist, the only one in the state of Delaware. Colorpuncture uses light rather than needles to address the non-physical origins of illness as well as its physical symptoms. “Certain areas of the immune system can be weakened by emotional problems. For example, stress and anxiety from work will weaken certain parts of the body,” says Frisa.
Colorpuncture uses different frequencies of light and color that help heal the body at a cellular level. “People have come in for treatment with 50 percent kidney function only to have it checked right after and it went up to 70 percent,” says Frisa. Each session is one hour and Frisa says his patients have also reported having more stamina and focus as a result.
Reiki is another holistic energy touch therapy administered to promote healing. It was developed in Japan in the early 20th century. Like reflexology and acupuncture, the Reiki practitioner seeks to change and balance the energy fields in and around the body to promote physical, psychological, emotional and spiritual welfare.
Reiki is based on the principle that the practitioner can channel energy into the patient by touch to activate the natural healing powers of the person’s body. This can be done with the hands placed just above the body or with actual light touch. The technique usually focuses on the seven main chakras—or energy points—and the joints of the extremities. The practitioner will concentrate on areas where the energy is believed to be stagnant and then, using intention, direct it to the desired location.
Reiki complements the work of acupuncture. “If you’re doing acupuncture, you’re working on the meridians which are sort of like the energy highways,” says Anita Brown, owner of Inspirit Studios in Magnolia. “With Reiki we focus on the chakras. We bring the energy in and the meridians carry it throughout the body.”
Because Reiki is non-invasive, there are no contraindications regarding treatment. Indeed, one advantage of Reiki is that it can be used in conjunction with other modalities across a variety of settings.
Brown has worked with women throughout pregnancy and childbirth, pre- and post-surgical patients as well as cancer and hospice patients.
However, science remains uncertain as to whether Reiki is helpful. Only a small number of studies have been completed with most of them including only a few people. Moreover, different studies look at different health conditions, making comparison difficult.
Yet experts note that any treatment that places patients in a state of relaxation can create a healing environment. Cancer patients in the UK reported feeling better following a Reiki session. They also said they were better able to cope with the symptoms and side effects of treatment.
Brown sees similar results in her practice. “Some of my clients have reported a decrease in pain and stress,” she says. “I had one client who got relief from tinnitus (ringing in the ears) and another from vertigo (loss of balance). It really depends.”
Yoga’s ancient mind-body science has found a place in today’s busy society.
According to a survey by the Sports & Fitness Industry Association, more than 24 million U.S. adults practiced yoga in 2013, making it almost as popular as golf.
Like other forms of complementary alternative medicine, yoga focuses on the body’s natural tendency toward health and self-healing.
There are many different types of yoga. Hatha—a combination of many styles—focuses on pranayamas (breath-controlled exercises). These are followed by a series of asanas (yoga poses), which end with savasana (a resting period).
The goal of a yoga session is to challenge yourself physically but not to feel overwhelmed, says Kathleen Wright, owner of Very Near Yoga Studio in Wilmington. Rather, the focus is on your breath while your mind remains accepting and calm.
Yoga’s benefits go beyond its ability to increase flexibility, improve balance and reduce stress. A recent study by Norwegian researchers found that practicing yoga results in changes in gene expression that boosts immunity at the cellular level. Wright says it’s all about movement. “When you move in these systematic ways, you’re not only stimulating blood flow, you’re also moving the lymphatic fluid through the lymph nodes and that’s a defense against illness and infection,” she says.
Yoga helps strengthen bones. Poses that strengthen the areas most likely to suffer from bone loss—the hip, spine and wrists—can help maintain bone density. Additionally, poses that target the spine can help improve posture, preventing the dowager hump that is typical in older osteoporosis sufferers. “There’s nothing more youthful looking than good posture,” says Wright.
Yoga can also relieve headaches. Headaches can be caused by a variety of factors but Wright cites our increased hunching over electronic devices as a major culprit. Poses that stretch the trapezius, neck and upper back muscles can reduce the frequency and severity of headaches.
Biologic agents also play an important role in integrative medicine. Herbal medicine and homeopathy both use natural products, but the way in which they use the botanicals is quite different.
Simply put, herbal medicine is the use of a plant’s seeds, berries, roots, leaves, bark or flowers to treat a problem. Plants have been the source of medicines for much of human history. But using herbs is different from using a plant-derived drug such as aspirin, which is derived from willow bark. “A chemical drug is one molecule whereas a plant can have three to four thousand different chemicals arranged in different configurations, creating a unique profile,” says Alan Tillotson, Ph.D., R.H., LAC, founding director of the Chrysalis Natural Medicine Clinic in Wilmington. “That can make it difficult to analyze them scientifically sometimes.”
Herbs can be taken in a variety of forms but the most popular are teas, tinctures and capsules. Teas are made by steeping the herb in hot water. A tincture extracts the therapeutic properties of the herb using alcohol and water. Tinctures can also be made with apple cider vinegar or glycerin. A capsule is filled with a dried or freeze-dried crushed herb.
Herbal therapies are extremely popular and interest in them is growing rapidly. According to a 2008 survey by the National Center for Health Statistics, nearly 20 percent of children and adults in the U.S. have used an herbal medicine during the past year.
Photo by Keith Mosher
Cheyenne Luzader, integrative health coordinator
Although they may seem harmless, herbal remedies can sometimes do more harm than good. “While an herb in and of itself might not be harmful, when some herbs are mixed with some pharmaceuticals, there can be harmful results,” says Cheyenne Luzader, integrative health coordinator at Beebe Healthcare in Lewes.
Luzader says patients must tell their healthcare providers about all the medications they are taking, including supplements and over-the-counter drugs.
Unlike plantal medicine, homeopathy is not a substance-based discipline where healing is the result of chemical reactions. Rather, it is a system based on the principle of “similars” or “like cures like.” This means that a remedy that treats a certain symptom is the same medicine that can produce in a healthy individual the exact symptom from which the person suffers.
Another difference: homeopathy uses other natural substances such as minerals or animal products.
A homeopathic remedy is prepared via serial dilution combined with vigorous shaking—called succussion—between each dilution. This process eliminates the toxicity of the medicinal agent while increasing its therapeutic benefits.
Science is still not sure how this process works but the shaking seems to change the physicality of the water so that it carries some of the properties of the active ingredient while making the remedy more tolerable to the body. “What we’re talking about here is nanochemistry,” says Dr. Ellen Feingold, director of the Homeopathy Center of Delaware in North Wilmington.
Onion juice will cause watery eyes and sneezing. But in a very diluted form it is useful in relieving eye and nasal irritation, as in hay fever.
Feingold is a medical doctor who practiced pediatrics for more than 30 years. She obtained her certificate in homeopathic medicine in 1996 from The Israel Medical College of Homeopathy.
Feingold now works in conjunction with primary care physicians treating patients of all ages. Her areas of specialization include musculoskeletal problems, nutritional ailments, chronic diseases and most types of cancer. “I’m not telling you I can cure cancer. Someone with cancer needs an oncologic doctor,” she says. “But when you’re finished with your treatments, I will help you prevent recurrence and I do that working with almost all cancers.”
Feingold notes that homeopathic medicine is slowly gaining acceptance in mainstream medicine. “I have a surprising number of doctors who refer to me but it’s never at the level that I like,” she says. “I’m not at the level where I’m happy with the interaction between alternative and conventional medicine. There’s still a divide in knowledge and appreciation of each other.”
(Chad Laurence, DC)
7503 Lancaster Pike, #A, Hockessin, 234-1115
Massage & Reflexology of Delaware
1601 Milltown Road, #15, Lindell Square, Wilmington, 633-4035
Very Near Yoga Studio
1301 Gilpin Avenue, Wilmington, 777-3484
Homeopathy Center of Delaware
(Dr. Ellen Feingold)
410 Foulk Road, #202, Wilmington, 764-1882
The Tillotson Institute of Natural Health
(Alan Tillotson, Ph.D., LAC)
1008 Milltown Road, Wilmington, 994-0565
Delaware Osteopathic Center
(Dr. Ellen Feingold)
(Seth Torregiani, DO—offers integrative health counseling plus performs acupuncture)
CGW Building, Suite 5, 2502 Silverside Road, Wilmington, 543-5435
Inspirit Studios (Reiki)
190 Dogwood Drive, Magnolia, 222-4804
Active Life Acupuncture and Wellness Center
28312 Lewes-Georgetown Highway
Department of Integrative Health
424 Savannah Road, Lewes, 645-3300