Alternative medicine just got about as big a vote of confidence as anyone could wish. The highly respected American Association of Orthopaedic Surgeons (AAOS) has told its members they need to learn more about alternative treatments that help ease patients' pain.

The group, which represents surgeons who specialize in treatment of musculoskeletal disorders, estimates that almost half of Americans have tried some form of "complementary and alternative medicine" (CAM).

An AAOS committee that studied the use of alternative disciplines like yoga and chiropractic found no evidence that people use one form of medicine to the exclusion of the other. They use alternatives "as an adjunct to their treatment, perhaps as a way to take back control of their own treatment," says John Wickenden, chairman of the association's Complementary and Alternative Medicine Committee.

Many patients don't tell their physicians they are using herbal supplements, and physicians don't ask, which can lead to problems. Such supplements can sometimes interact dangerously with prescription drugs. "Some of these herbs pose discrete risks, such as excessive bleeding during surgery or interaction with anesthetics." Dong quai, ginger, garlic, gingko biloba, ginseng and St. John's wort "may increase bleeding."

Wickenden's committee believes orthopaedic surgeons may have to drop their hostility to chiropractic. "Frequently we M.D. types are too focused on the narrow pathology we are pursuing," he "But obviously this pathology occurs in a whole person."

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