**2. Types of complementary therapies**

The National Institutes of Health has grouped TCAM into five overlapping domains, namely, biologically based therapies, manipulative and body-based approaches, mind-body medicine, alternative medical systems, and energy medicine [1, 12]. Some complimentary therapies are discussed as follows:


Though appearing crude because of the lack of the use of X-ray, it has recorded tremendous success. The bonesetter may often make used of herbs to relieve pain and promote healing and may use primitive forms of straps and wooden splints to hold the bone in place.


Based on literature, biological therapies, such as the use of herbal and animal products, are the most common forms of TCAM used in Sub-Saharan Africa, followed by faith-based healing methods, such as prayer/spirituality [17, 18], and mind and body therapies (traditional bone setting, meditation and yoga, massage, relaxation, and music and art therapy). Others include acupuncture, Tai chi and Qi gong, massage, hydrotherapy, physical activity, and diet and nutrition [19]. Some of these health practices, though not originally African, have been adopted overtime and are included in complementary therapies practiced today in modern Africa, especially Chinese medicine due to the recently increased influx of the Chinese into Africa.

Acupuncture is a form of complementary medicine and a component of traditional Chinese medicine and is one of the imported complementary therapies in Africa [20, 21]. It involves the use of very thin needles or pressure to stimulate specific points on the body. Acupuncture causes changes in the fascia, which is the connective tissue that covers the muscles and bones. This can lead to changes in the brain, such as the release of chemicals like serotonin or changes in electrical activity. These changes are thought to explain, in part, how acupuncture works to treat different symptoms. Acupuncture has been used for the alleviation of pain [22], nausea, vomiting [23], fertility, childbirth chronic asthma, epilepsy, and addiction, among others. The efficacy of acupuncture is considered to be due to the release of endorphins and the stimulation of the peripheral nervous system when the skin is punctured [24]. The safety of acupuncture is assured when administered by welltrained practitioners using sterile needles. However, being an invasive procedure, adverse effects have been reported, such as hemorrhage, hematoma and bacterial infection, nerve injuries, hepatitis, kidney damage, etc. [25].

*Homeopathy:* According to the principles of homoeopathy, certain remedies, when given in high concentrations, tend to mimic the symptoms presented by the patient, and that upon dilution and vigorous shaking releases the curative "essence." Dilution continues until no more of the original substance remains, but the water molecules are believed to retain a "memory" of the original substance [26]. While no scientific evidence has been found to support the theories of homeopathy, some successes have been reported. Randomized clinical trials have suggested that it might be effective for treating influenza, allergies, and postoperative ileum [12]. Some schools of thought consider it to be a little more effective than placebo [27].

#### *African Traditional and Complementary Therapies DOI: http://dx.doi.org/10.5772/intechopen.103060*

Yoga is another important aspect of complementary therapies. Yoga promotes slow breathing techniques used to relax mind and body, as well as to increase oxygenation [28]. It reduces stress and anxiety by using breathing exercises, meditation, relaxation techniques, and poses to stretch and flex different muscle groups. Yoga also calms the mind and connects mind and body. Studies have shown that yoga increases the activities of the parasympathetic nervous system by releasing γ-amino butyric acid, GABA [29].

The benefits of yoga include improved overall quality of life, increased physical functioning, and increased ability to conduct the activities of daily living. Yoga also improves mood and physical well-being, improves nausea, reduces pain and fatigue, improves sleep problems, and helps regulate stress hormones. It also decreases inflammation and increases immune function.

Tai chi and Qi gong are part of traditional Chinese medicine that combine a series of fluid movements, which are slow and deliberate, meditation, regulated breathing, and calming of the mind, thus enhancing physical health and emotional well-being. Derived from martial art, Tai chi and Qi gong can improve the quality of life, reduce sleep problems, and decrease inflammation. Tai chi is based on spiritual and philosophical ideas that advocate for a need for balance in the body, mind, and spirit, with the notion that life energy or "*chi*" needs to flow freely for good health to occur. Qi gong, also derived from martial art, on the other hand, trains both body and soul and focuses on the relationship between the individual and the cosmic environment [30, 31].

Meditation is the practice of focusing your attention to calm the mind and relax the body. Sometimes, a calming word or chant is silently repeated. Other times, there is only focus on breathing or just being aware of thoughts and feelings with no judgment, attachment, or interpretation. Meditation can be self-taught or guided by others. There are many different types, including focused meditation, open awareness and mindfulness, and compassion or loving-kindness meditation, with or without religious undertone. Studies show that meditation can decrease chronic pain, improve mood and many other aspects of quality of life, lower stress hormones, and improve immune function [32].

Music therapy involves the use of musical and rhythm-based interventions to support and develop physical, mental, social, and spiritual well-being. It is a noninvasive, nonpharmaceutical, relatively inexpensive but effective therapy, which targets improvements in cognitive function and physical rehabilitation. Music has been shown to have psychosocial, behavioral, and motor benefits as treatment for neurological dysfunctions. Music induces changes by linking brain regions within multisensory and motor networks, thereby having effects on emotion and reward systems. Evidence suggests that music-based therapy improves balance and functional mobility in patients with Parkinson's disease and positive benefits in dementia as well as mitigating pain, improving blood flow and joint flexion required for a more rapid healing process during the rehabilitation phase after stroke [33, 34].

Art therapy is a form of complementary psychotherapy that uses artistic materials (visual art, painting, and drawing) as palliative care focused on relieving suffering patient with serious illness to ameliorate symptom burden and adapt to the stressful life experiences associated with life-limiting diagnosis. It utilizes the expressive qualities of art to improve physical, mental, and emotional well-being. It also improves cognitive and semimotor functions, fosters self-esteem and self-awareness, cultivates emotional resilience, promotes insight, enhances social skills, reduces and resolves conflict and distress, and advances societal and ecological changes. Art therapy is used mainly for cancer, depression, anxiety, autism, dementia, and cognitive impairment, especially in situations when verbal interaction becomes difficult and provides a safe and indirect way to connect oneself to others [35, 36].

#### *Complementary Therapies*

Massage can help promote relaxation, ease tension, increase comfort, and reduce pain, especially in musculoskeletal conditions. People with cancer may especially benefit from massage and its subspecialty called oncology massage. In addition to receiving massage from a massage therapist, a caregiver can do simple massage to help relax. It is also possible to do a self-massage [32].

Research shows that massage can reduce pain, decrease tension and stress, help with recover after surgery, ease anxiety and depression, and help with sleep problems and fatigue [32].

*Regular exercise*: A growing amount of research shows that exercise can greatly improve different aspects of patients' physical and mental health during every phase of treatment. An exercise program can rejuvenate a patient, if used appropriately [37].
