Ask the Doctor

Alternative Medicine and Hand Surgery

By Dr. John S. Taras
Reprinted here from the Fall 2001 "First Hand News"

As I researched information to write this article, I began where many of my patients begin their queries: the Internet. When I tapped into one popular search engine, I was rewarded with an enormous list of sites devoted to holistic and alternative cures for ailments from Arthritis to Zoster. As I sifted through the entries, I was faced with same challenge my patients encounter in finding answers to questions such as: What exactly is holistic medicine? Can alternative treatment help hand and upper extremity conditions? What methods are safe? Will any of these treatments harm me?

A more traditional search yielded some answers. A special report prepared for the National Institutes of Health categorizes alternative medicine practices into five fields. These are:

1. Alternative systems of medical practice
2. Mind-body intervention
3. Touch and manipulation
4. Pharmacological and biographical treatments
5. Bioelectromagnetic applications

A major difference between alternative and conventional medicines is conventional medicine prides itself in recommending methods that have been proven in clinical studies using standard scientific methods. Alternative medicine is much more open to recommending what appears to work for the individual, yet proof of effectiveness is not well documented. In conventional medicine, the Food and Drug Administration (FDA) ensures that drugs undergo testing to ensure their safety and effectiveness, uniformity, and purity. Herbal remedies available at health food stores, the Internet, and mail-order catalogs are not subject to the rigorous scrutiny of the FDA, as such dosage information, drug interactions and contraindications often are not easily available to the consumer. While conventional medicine or Western medicine focuses on the illness, alternative medicine places emphasis on the whole person, also known as the holistic approach. The holistic approach views health as a complex product of body, mind, and spirit, and advocates use of one of the five methods described above.

When my patients ask me if I recommend holistic therapies such as acupuncture, Vitamin B6, magnets, meditation, and the like, my suggestion is to keep your options open. Realize that some conditions, such as carpal tunnel syndrome, are mechanical in nature and are in the end most successfully treated surgically and that the symptoms of some conditions become irreversible if not properly treated early in their course. Patients who subscribe to a holistic philosophy for any medical condition should keep in mind that symptoms not responding to any therapy over a period of time may be serious and that they should seek a consultation with a qualified medical doctor. Patients should realize that both conventional and alternative practitioners can overestimate the benefits of their treatments and there is no miracle cure for any disease.

When considering treatment options, a red flag should be raised if information about any medication or treatment is unavailable at a library, literature search, or through a physician.

Patients should also remember that just because a medication is plant-based, it is not necessarily nontoxic. Many drugs, including digitalis (used to treat heart conditions) and tamoxifen (used to treat certain typed of cancer) are derived from plants and exert powerful forces on the body. The risk-benefit ratio strongly favors approved drugs prescribed by a licensed practitioner. Also suspect are claims that herbal remedies from Africa, India, and the Far East are any more reliable than the over-the-counter medications recommended for some hand and upper extremity repetitive use conditions. Any treatment regimen recommended by a practitioner without first obtaining the patient's history, physical, and diagnosis should be dismissed.

While Western and alternative medicine have diverged in their philosophies of disease, they share the common goal of promoting patient wellness. It should be kept in mind that many medical approaches once considered alternatives are now part of mainstream medicine, including biofeedback, stress reduction techniques such as yoga and meditation, and lifestyle approaches such as good nutrition and exercise. As holistic medicine gains popularity, its mechanisms will no doubt undergo testing in the traditional scientific manner. Until that time, patients should keep an open mind but understand the drawbacks and limitations of alternative medicine. The Internet provides a myriad of references for treating practically every condition, but it should only be used a springboard for further inquiries. In an age when information is available with a few keystrokes, I continue to urge my patients to take interest and responsibility in their medical care and to prevent additional harm through alternative cures.

For more information or to schedule an appointment, please call 1-800-971-HAND (4263).

I would like to thank Lucy McCabe, my academic assistant, for her contributions to this article.