The doctor is in. So is the yogi.
A sharp shift in health care is taking place as more than one-third of American adults now supplement or substitute mainstream medical care with acupuncture, meditation, yoga and other therapies long considered alternative.
In 2022, 37 percent of adult pain patients used nontraditional medical care, a marked rise from 19 percent in 2002, according to research published this week in JAMA. The change has been propelled by growing insurance reimbursement for clinical alternatives, more scientific evidence of their effectiveness and an increasing acceptance among patients.
“It’s become part of the culture of the United States,” said Richard Nahin, the paper’s lead author and an epidemiologist at the National Center of Complementary and Integrative Health, a division of the National Institutes of Health. “We’re talking about the use for general wellness, stress management use, sleep, energy, immune health.”
And for pain management. The use of yoga to manage pain rose to 29 percent in 2022 from 11 percent in 2002, an increase that Dr. Nahin said reflected in part efforts by patients to find alternatives to opiates, and the influence of media and social media.
“It’s in the public domain so much,” he said. “People hear acupuncture, meditation, yoga. They start to learn.”
The change is impacting medical practitioners as well. Dr. Sean Mackey, chief of the pain medicine division at Stanford Medicine, said that a growing number of studies have validated alternative therapies, providing even traditional clinics like Stanford’s with more mind-body therapies and other nonpharmaceutical tools. He said the acceptance of those ideas has grown among younger people in particular, whereas patients of earlier generations may have seen these options as too out there.
“Our parents and our grandparents would look at them and they’re like, What, are you kidding me?”
At the same time, Dr. Mackey said, the growing prominence of the therapies can be a “double-edged sword” because they do not always provide the relief that is marketed.
“My advice to people when they’re pursuing this is to do these things for a trial,” he said. “But if it’s not providing long-term durable benefits, don’t just keep doing it.”
The JAMA article drew its data from the 2002, 2012 and 2022 National Health Interview Survey, which was conducted in person and by telephone. Researchers used the data to evaluate the use of seven complementary health care approaches: acupuncture, chiropractic care, guided imagery, massage therapy, meditation, naturopathy and yoga.
Meditation as a health therapy jumped sharply, to around 17 percent of American adults in 2022, from around 7.5 percent two decades earlier. Dr. Nihan said that the low cost was a factor: “How much does it cost to do meditation and yoga?” Such activities vary widely in price, depending on whether they are done at home or in classes.
For some people, the alternatives seem to prove superior. Jee Kim started down the traditional-medicine path in 2022 when he was grappling with sleeplessness and anxiety from a separation. His primary care doctor in Boulder, Colo., prescribed medications that Mr. Kim used initially but found to have intolerable side effects.
“I got serious about yoga and meditation,” he said, ultimately finding them a better solution. “I tried the pharmaceutical route, but I wanted tools I could come back to. I knew it wouldn’t be my last hard life transition.”
Mr. Kim, 49, a political consultant and a former college tennis player who still plays avidly, also credits yoga with helping stave off injury, so much so that he has become an occasional yoga instructor himself. “It’s a pillar of my physical and mental health, at work too,” he said.
Dr. Jennifer Rhodes, a psychiatrist in Boulder who specializes in treating women going through hormonal changes, said that a “majority of my patients use supplementary intervention like those for stress management,” referring to the therapies in the survey.
She said that she embraced the concept but cautioned that medications can be crucial, too.
“Do acupuncture and massage,” she said. “But it’s not fair to ask for someone who is severely depressed or anxious and not functioning to employ those until they calm their nervous system down.”