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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