Integrative healthcare (IH) is used to treat the whole person from a variety of perspectives including mental, emotional, functional, and physical aspects. Some providers – such as naturopathic physicians – can function as primary care providers. Other, such as massage therapists and chiropractors are a great fit for treating musculoskeletal conditions. Recent research into acupuncture has shown its efficacy in treating chronic pain. We recommend that patients seeking treatment for health conditions consult the National Center for Complementary and Integrative Health website at nccih.nih.gov for the latest evidence and research on conditions treated by these type of healthcare providers.

Definition: Acupuncture is the stimulation of certain points in the body with the insertion of fine metallic needles into the skin and deeper tissues.

Training & Licensing: Licensed acupuncturists in the US must receive training from a school approved by the Accreditation Commission for Acupuncture and Oriental Medicine (recognized by the U.S. Department of Education for accrediting Masters and Doctoral-level educational programs). Prerequisites for acceptance into an acupuncture program include three years of college credits with special emphasis on biology, chemistry, and psychology, though most entrants will have a bachelor’s degree or higher.

After graduation, acupuncturists sit for the national board examinations. Once nationally certified, they must also become licensed in their jurisdiction. Currently, all but four states require licensure for legal practice.

At Your Visit: During your first visit, the acupuncturist will inquire about your current health concerns and health history including lifestyle, medications, and any symptoms you are experiencing. They may also note various physical characteristics by examining the color, shape, and coating of your tongue; feel the speed, quality, and strength of your pulse; or examine areas of your body where you are experiencing pain or discomfort.

During your treatment, acupuncture needles will be inserted at specific spots on your body, just deep enough into the skin to keep them from falling out. Acupuncture needles are much smaller than a hypodermic needle and the point is rounded, not sharp. Most patients do not experience any pain during the insertion of an acupuncture needle. In fact, patients report that they find their acupuncture treatments very pleasant – some people even fall asleep! If you do experience any unusual pain or discomfort during the treatment, let your provider know right away so they can adjust or remove any needle as needed.

Definition: Chiropractic care focuses on disorders of the musculoskeletal and nervous systems and the effects these have on the patient’s general health. Chiropractic care is primarily used to treat joint and muscle pain problems. Chiropractic treatments often include spinal manipulation and other joint and soft tissue manipulation techniques. Chiropractors can provide instruction and information on exercise, nutrition and health, and lifestyle counseling.

Training & Licensing: Chiropractic physicians complete an extensive education that includes a four-year bachelor’s degree and three years at an accredited chiropractic college. Like other primary healthcare providers, a significant portion of their training is on focused on clinical subjects related to evaluating and caring for patients. After graduation, chiropractors must pass the National Board of Chiropractic Examiners test and apply for licensure in their jurisdiction.

At Your Visit: At your first visit, you will be asked to provide a full health history including lifestyle, medications, and any symptoms you are experiencing. After taking a complete history, your chiropractor will use a variety of hands-on neurologic, orthopedic, and specialized chiropractic tests to identify problems that may require treatment. These are physical maneuvers and other examinations that assess the function of joints, muscles and nerves throughout the body such as palpation, range of motion, strength, sensation, and reflexes. Chiropractors perform these tests to determine if there might be other conditions that require a referral to another medical specialty.

After the physical exam, your chiropractor may perform spinal or other joint manipulation (aka “adjustment”) or other treatments including massage, ultrasound, cold or heat therapy, or TENS therapy.

Definition: Massage therapy is the manipulation of the muscles and other soft tissues of the body using hands, fingers, forearms and/or elbows. There are many different types of massage therapy including Swedish massage, deep tissue massage, sports massage, and myofascial release. Massage therapy can be used both for relaxation and as part of a course of treatment for medical conditions.

Training & Licensing: Requirements for training and licensing vary by jurisdiction, however, most requirements include completion of a massage training program with a required number of hours of instruction (up to 1,000 in some areas), as well as a demonstration of professionalism and a detailed background check. Massage therapy training programs include courses in the study of anatomy and physiology, the theory and practice of massage therapy, and other elective subjects. Currently, 44 states and the District of Columbia have licensure requirements for massage therapists.

At Your Visit: At your first visit, your massage therapist should conduct an intake interview to determine what your goals are in seeking massage therapy. For example, they might ask if you need help with a specific condition or injury or if massage going to be a part of your wellness program. The therapist will also determine if you have any conditions that would be of concern for massage.

Your massage therapist should clearly explain the procedures they will be performing during your treatment, assess your comfort with removing clothing, and provide you with a safe and private environment for a massage.

Definition: Naturopathic medicine emphasizes prevention and the self-healing process using of natural therapies, nutritional support, lifestyle counselling, physical medicine, and other supportive care.

Naturopathic physicians focus on identifying and treating the underlying causes of disease. Naturopathic treatments are supported by research drawn from peer-reviewed journals from many disciplines. A naturopathic physician’s approach is to help the patient heal themselves with appropriate natural medicines and activities that do not cause harm to the patient.

Training & Licensing: A licensed naturopathic physician (ND) attends a four-year, graduate-level accredited naturopathic medical school and is educated in all of the same basic sciences as a conventional medical doctor. They also study holistic and non-toxic treatments with a strong emphasis on disease prevention and optimizing wellness. In addition to the standard medical curriculum, naturopathic physicians are required to complete of training in clinical nutrition, acupuncture, homeopathic medicine, botanical medicine, psychology, and counseling.

Currently, 17 states license naturopathic physicians – including Oregon, Washington, Utah, Alaska, Montana, and Colorado. To become licensed, graduates must pass a national biomedical and clinical science licensing exam and apply for a license in their jurisdiction. Once licensed, naturopathic physicians have continuing education requirements to ensure their life-long learning.

At Your Visit: At your first visit, the naturopathic physician will take a thorough health history; they will also perform any necessary physical examination as well as laboratory tests when needed. A naturopathic physician may ask you about aspects of your history that may surprise you including inquiries about physical, mental, emotional or spiritual aspects of your wellbeing. This can assist your provider in determining but what may be an underlying cause of your problem. This can be especially true in chronic conditions, where an illness itself can impact many areas of life. Their goal is to identify the cause of your disease or discomfort, utilize safe and effective natural means of treating your symptoms, and help you make sustainable changes in your life to prevent further problems.

You may choose to have a naturopathic physician as your primary care provider or see them for a specific condition. Your naturopathic physician will work in cooperation with other healthcare providers when this is warranted and may refer you to other specialists.