Introduction
Energy medicine is a
domain in CAM that deals with energy fields of two types1:
- Veritable, which
can be measured
- Putative, which
have yet to be measured
The veritable
energies employ mechanical vibrations (such as sound)
and electromagnetic forces, including visible light,
magnetism, monochromatic radiation (such as laser
beams), and rays from other parts of the electromagnetic
spectrum. They involve the use of specific, measurable
wavelengths and frequencies to treat patients.2
In contrast,
putative energy fields (also called biofields) have
defied measurement to date by reproducible methods.
Therapies involving putative energy fields are based on
the concept that human beings are infused with a subtle
form of energy. This vital energy or life force is known
under different names in different cultures, such as qi
in traditional Chinese medicine (TCM), ki in the
Japanese Kampo system, doshas in Ayurvedic medicine, and
elsewhere as prana, etheric energy, fohat, orgone, odic
force, mana, and homeopathic resonance.3
Vital energy is believed to flow throughout the material
human body, but it has not been unequivocally measured
by means of conventional instrumentation. Nonetheless,
therapists claim that they can work with this subtle
energy, see it with their own eyes, and use it to effect
changes in the physical body and influence health.
Practitioners of energy
medicine believe that illness results from disturbances
of these subtle energies (the biofield). For example,
more than 2,000 years ago, Asian practitioners
postulated that the flow and balance of life energies
are necessary for maintaining health and described tools
to restore them. Herbal medicine, acupuncture,
acupressure, moxibustion, and cupping, for example, are
all believed to act by correcting imbalances in the
internal biofield, such as by restoring the flow of qi
through meridians to reinstate health. Some therapists
are believed to emit or transmit the vital energy
(external qi) to a recipient to restore health.4
Examples of practices
involving putative energy fields include:
- Reiki and Johrei,
both of Japanese origin
- Qi gong, a Chinese
practice
- Healing touch, in
which the therapist is purported to identify
imbalances and correct a client's energy by passing
his or her hands over the patient
- Intercessory
prayer, in which a person intercedes through prayer
on behalf of another
In the aggregate, these
approaches are among the most controversial of CAM
practices because neither the external energy fields nor
their therapeutic effects have been demonstrated
convincingly by any biophysical means. Yet, energy
medicine is gaining popularity in the American
marketplace and has become a subject of investigations
at some academic medical centers. A recent National
Center for Health Statistics survey indicated that
approximately 1 percent of the participants had used
Reiki, 0.5 percent had used qi gong, and 4.6 percent had
used some kind of healing ritual.5
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Scope of the Research
Veritable Energy
Medicine
There are many well-established uses for the application
of measurable energy fields to diagnose or treat
diseases: electromagnetic fields in magnetic resonance
imaging, cardiac pacemakers, radiation therapy,
ultraviolet light for psoriasis, laser keratoplasty, and
more. There are many other claimed uses as well. The
ability to deliver quantifiable amounts of energies
across the electromagnetic spectrum is an advantage to
studies of their mechanisms and clinical effects. For
example, both static and pulsating electromagnetic
therapies have been employed.2
Magnetic Therapy
Static magnets have been used for centuries in efforts
to relieve pain or to obtain other alleged benefits
(e.g., increased energy). Numerous anecdotal reports
have indicated that individuals have experienced
significant, and at times dramatic, relief of pain after
the application of static magnets over a painful area.
Although the literature on the biological effects of
magnetic fields is growing, there is a paucity of data
from well-structured, clinically sound studies. However,
there is growing evidence that magnetic fields can
influence physiological processes. It has recently been
shown that static magnetic fields affect the
microvasculature of skeletal muscle.6
Microvessels that are initially dilated respond to a
magnetic field by constricting, and microvessels that
are initially constricted respond by dilating. These
results suggest that static magnetic fields may have a
beneficial role in treating edema or ischemic
conditions, but there is no proof that they do.
Pulsating
electromagnetic therapy has been in use for the past 40
years. A well-recognized and standard use is to enhance
the healing of nonunion fractures. It also has been
claimed that this therapy is effective in treating
osteoarthritis, migraine headaches, multiple sclerosis,
and sleep disorders.2 Some
animal and cell culture studies have been conducted to
elucidate the basic mechanism of the pulsating
electromagnetic therapy effect, such as cell
proliferation and cell-surface binding for growth
factors. However, detailed data on the mechanisms of
action are still lacking.
Millimeter Wave
Therapy
Low-power millimeter wave (MW) irradiation elicits
biological effects, and clinicians in Russia and other
parts of Eastern Europe have used it in past decades to
treat a variety of conditions, ranging from skin
diseases and wound healing to various types of cancer,
gastrointestinal and cardiovascular diseases, and
psychiatric illnesses.7 In
spite of an increasing number of in vivo and
in vitro studies, the nature of MW action is not
well understood. It has been shown, for example, that MW
irradiation can augment T-cell mediated immunity in
vitro.8 However, the
mechanisms by which MW irradiation enhances T-cell
functions are not known. Some studies indicate that
pretreating mice with naloxone may block the hypoalgesic
and antipruritic effects of MW irradiation, suggesting
that endogenous opioids are involved in MW
therapy-induced hypoalgesia.9
Theoretical and experimental data show that nearly all
the MW energy is absorbed in the superficial layers of
skin, but it is not clear how the energy absorbed by
keratinocytes, the main constituents of epidermis, is
transmitted to elicit the therapeutic effect.10
It is also unclear whether MW yields clinical effects
beyond a placebo response.
Sound Energy Therapy
Sound energy therapy, sometimes referred to as
vibrational or frequency therapy, includes music therapy
as well as wind chime and tuning fork therapy. The
presumptive basis of its effect is that specific sound
frequencies resonate with specific organs of the body to
heal and support the body. Music therapy has been the
most studied among these interventions, with studies
dating back to the 1920s, when it was reported that
music affected blood pressure.11
Other studies have suggested that music can help reduce
pain and anxiety. Music and imagery, alone and in
combination, have been used to entrain mood states,
reduce acute or chronic pain, and alter certain
biochemicals, such as plasma beta-endorphin levels.12
These uses of energy fields truly overlap with the
domain of mind-body medicine. (For more information, see
NCCAM's backgrounder "Mind-Body Medicine: An Overview.")
Light Therapy
Light therapy is the use of natural or artificial light
to treat various ailments, but unproven uses of light
extend to lasers, colors, and monochromatic lights.
High-intensity light therapy has been documented to be
useful for seasonal affective disorder, with less
evidence for its usefulness in the treatment of more
general forms of depression and sleep disorders.13
Hormonal changes have been detected after treatment.
Although low-level laser therapy is claimed to be useful
for relieving pain, reducing inflammation, and helping
to heal wounds, strong scientific proof of these effects
is still needed.14
Energy Medicine
Involving Putative Energy Fields
The concept that sickness and disease arise from
imbalances in the vital energy field of the body has led
to many forms of therapy. In TCM, a series of approaches
are taken to rectify the flow of qi, such as herbal
medicine, acupuncture (and its various versions), qi
gong, diet, and behavior changes.
Acupuncture
Of these approaches, acupuncture is the most prominent
therapy to promote qi flow along the meridians.
Acupuncture has been extensively studied and has been
shown to be effective in treating some conditions,
particularly certain forms of pain.1
However, its mechanism of action remains to be
elucidated. The main threads of research on acupuncture
have shown regional effects on neurotransmitter
expression, but have not validated the existence of an
"energy" per se.
Qi Gong
Qi gong, another energy modality that purportedly can
restore health, is practiced widely in the clinics and
hospitals of China. Most of the reports were published
as abstracts in Chinese, which makes accessing the
information difficult. But Sancier has collected more
than 2,000 records in his qi gong database which
indicates that qi gong has extensive health benefits on
conditions ranging from blood pressure to asthma.15
The reported studies, however, are largely anecdotal
case series and not randomized controlled trials. Few
studies have been conducted outside China and reported
in peer-reviewed journals in English. There have been no
large clinical trials.
Whole Medical
Systems and Energy Medicine
Although modalities such as acupuncture and qi gong have
been studied separately, TCM uses combinations of
treatments (e.g., herbs, acupuncture, and qi gong) in
practice. Similarly, Ayurvedic medicine uses
combinations of herbal medicine, yoga, meditation, and
other approaches to restore vital energy, particularly
at the chakra energy centers. (For more information on
TCM and Ayurvedic medicine, see NCCAM's backgrounder
"Whole Medical Systems: An Overview.")
Homeopathy
One Western approach with implications for energy
medicine is homeopathy. Homeopaths believe that their
remedies mobilize the body's vital force to orchestrate
coordinated healing responses throughout the organism.
The body translates the information on the vital force
into local physical changes that lead to recovery from
acute and chronic diseases.
Homeopaths use their assessment of the deficits in vital
force to guide dose (potency) selection and treatment
pace, and to judge the likely clinical course and
prognosis. Homeopathic medicine is based on the
principle of similars, and remedies are often prescribed
in high dilutions. In most cases, the dilution may not
contain any molecules of the original agents at all. As
a consequence, homoeopathic remedies, at least when
applied in high dilutions, cannot act by pharmacological
means. Theories for a potential mechanism of action
invoke the homeopathic solution, therefore, postulating
that information is stored in the dilution process by
physical means. Other than a study reported by the
Benveniste laboratory and
other smaller studies, this hypothesis has not been
supported by scientific research. There have been
numerous clinical studies of homeopathic approaches, but
systematic reviews point out the overall poor quality
and inconsistency of these studies.
Therapeutic Touch
and Related Practices
Numerous other practices have evolved over the years to
promote or maintain the balance of vital energy fields
in the body. Examples of these modalities include
Therapeutic Touch, healing touch, Reiki, Johrei, vortex
healing, and polarity therapy.
All these modalities involve movement of the
practitioner's hands over the patient's body to become
attuned to the condition of the patient, with the idea
that by so doing, the practitioner is able to strengthen
and reorient the patient's energies.
Many small studies of
Therapeutic Touch have suggested its effectiveness in a
wide variety of conditions, including wound healing,
osteoarthritis, migraine headaches, and anxiety in burn
patients. In a recent meta-analysis of 11 controlled
Therapeutic Touch studies, 7 controlled studies had
positive outcomes, and 3 showed no effect; in one study,
the control group healed faster than the Therapeutic
Touch group. Similarly,
Reiki and Johrei practitioners claim that the therapies
boost the body's immune system, enhance the body's
ability to heal itself, and are beneficial for a wide
range of problems, such as stress-related conditions,
allergies, heart conditions, high blood pressure, and
chronic pain. However,
there has been little rigorous scientific research.
Overall, these therapies have impressive anecdotal
evidence, but none has been proven scientifically to be
effective.
Distant Healing
Proponents of energy field therapies also claim that
some of these therapies can act across long distances.
For example, the long-distance effects of external qi
gong have been studied in China and summarized in the
book Scientific Qigong Exploration, which has
been translated into English.
The studies reported various healing cases and described
the nature of qi as bidirectional, multifunctional,
adaptable to targets, and capable of effects over long
distances. But none of these claims has been
independently verified. Another form of distant healing
is intercessory prayer, in which a person prays for the
healing of another person who is a great distance away,
with or without that person's knowledge. Review of eight
nonrandomized and nine randomized clinical trials
published between 2000 and 2002 showed that the majority
of the more rigorous trials do not support the
hypothesis that distant intercessory prayer has specific
therapeutic effects.
Physical Properties
of Putative Energy Fields
There has always been an interest in detecting and
describing the physical properties of putative energy
fields. Kirlian photography, aura imaging, and gas
discharge visualization are approaches for which
dramatic and unique differences before and after
therapeutic energy attunements or treatments have been
claimed. However, it is
not clear what is being detected or photographed. Early
results demonstrated that gamma radiation levels
markedly decreased during therapy sessions in 100
percent of subjects and at every body site tested,
regardless of which therapist performed the treatment.
Recently replicated studies identified statistically
significant decreases in gamma rays emitted from
patients during alternative healing sessions with
trained practitioners.
It has been
hypothesized that the body's primary gamma emitter,
potassium-40 (K40), represents a "self-regulation" of
energy within the body and the surrounding
electromagnetic field.
The body's energy adjustment may result, in part, from
the increased electromagnetic fields surrounding the
hands of the healers. Furthermore, an extremely
sensitive magnetometer called a superconducting quantum
interference device (SQUID) has been claimed to measure
large frequency-pulsing biomagnetic fields emanating
from the hands of Therapeutic Touch practitioners during
therapy. In one study, a
simple magnetometer measured and quantified similar
frequency-pulsing biomagnetic fields from the hands of
meditators and practitioners of yoga and qi gong. These
fields were 1,000 times greater than the strongest human
biomagnetic field and were in the same frequency range
as those being tested in medical research laboratories
for use in speeding the healing process of certain
biological tissues. This
range is low energy and extremely low frequency,
spanning from 2 Hz to 50 Hz. However, there are
considerable technical problems in such research. For
example, SQUID measurement must be conducted under a
special shielded environment, and the connection between
electromagnetic field increases and observed healing
benefits reported in the current literature is missing.
Other studies of
putative energies suggested that energy fields from one
person can overlap and interact with energy fields of
other people. For example, when individuals touch, one
person's electrocardiographic signal is registered in
the other person's electroencephalogram (EEG) and
elsewhere on the other person's body.
In addition, one individual's cardiac signal can be
registered in another's EEG recording when two people
sit quietly opposite one another.
Additional Theories
Thus far, electromagnetic energy has been demonstrated
and postulated to be the energy between bioenergy
healers and patients. However, the exact nature of this
energy is not clear. Among the range of ideas emerging
in this field is the theory of a Russian researcher who
recently hypothesized that "torsion fields" exist and
that they can be propagated through space at no less
than 109 times the speed of light in vacuum;
that they convey information without transmitting
energy; and that they are not required to obey the
superposition principle.
There are other
extraordinary claims and observations recorded in the
literature. For example, one report claimed that
accomplished meditators were able to imprint their
intentions on electrical devices (IIED), which when
placed in a room for 3 months, would elicit these
intentions, such as changes in pH and temperature, in
the room even when the IIED was removed from the room.
Another claim is that water will crystallize into
different forms and appearances under the influence of
written intentions or types of music.
For research, questions
remain about which of the above theories and approaches
can be and should be addressed using existing
technologies, and how.
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