Alternative medicine: to what, exactly is it an alternative?

I recently read an article from the February 23, 2010 edition of the journal, Depression and Anxiety, that left me pondering what, exactly, is meant by "Alternative Medicine." The study in question looked at the efficacy of therapeutic massage for treating Generalized Anxiety Disorder. Not surprisingly, it apparently works. So did several of the other types of relaxation techniques presumably used as a sort of control in the study, namely relaxing in a quiet room, and thermotherapy (the application heat to body).

Fine. So be it; to the degree that the study was performed reliably by competent researchers, using rigorous, well conceived and implemented protocols, it may be provisionally accepted. My question is this: how is massage alternative medicine? We're talking real, hands-on-the-skin, rubbing of the soft tissues here. This is not mystical energy manipulation, Reiki, chakra balancing, or psychic surgery. Soft tissue massage is a well established therapeutic modality generally accepted as treatment for certain medical problems. The notion that massage would promote relaxation is certainly plausible--perhaps even common sense. The notion that relaxation helps relieve the symptoms of generalized anxiety is also generally well established.

By definition, alternative medicine is an alternative to something else. In this case, it is an alternative to this vague concept of "established medicine." For the purposes of this post, I am defining established medicine as the practice of medicine using an evidence-based (or science-based, using the phrase coined by Dr. Steven Novella) approach to patient care. Mainstream medicine is a continuously transforming thing; it morphs to accommodate ever-increasing knowledge and understanding. As diseases, prevention, and treatment become better understood, the practice of medicine changes to reflect that understanding. In essence, modern medicine reflects the scientific method.

Sometimes, treatments that were initially considered "alternative" become mainstream by passing scientific muster. In this sense, alternative simply means unproven. Once a treatment is adequately proven to work, it becomes mainstream, not alternative. Great! That's a system that is self-correcting and always improving.

So, really, alternative medicine is just an alternative to a scientific approach to diagnosis and treatment. If its not based on science, what is alternative medicine based on? Probably crap. Is that what you want to be treated with? Not me.