Alternative medicine is starting to emerge from the long, bitter battles between believers and debunkers, often waged in the virtual absence of scientific evidence. Treatments such as acupuncture, massage, guided imagery, relaxation training, therapeutic touch, tai chi, and yoga are now used in clinics and hospitals alongside conventional treatments. Indeed, such methods are now often called "complementary" or "integrative" medicine. Mainstream medical schools offer courses in alternative methods. Most important, alternative therapies are being tested in well-designed clinical trials, and reliable evidence about safety and efficacy is starting to emerge.

To find out if your knowledge and beliefs about alternative medicine are based on today's facts, take the following quiz. (Herbs and supplements are not included, since we often write about them in other reports.)

True or false: Having confidence in a treatment is more important for alternative remedies than for standard treatments.
False. Many aspects of alternative medicine may promote high expectations, such as ample time with the practitioner, attention to the whole person, and the prestige of ancient therapies. But there's plenty of evidence that expectations can shape the outcomes of conventional treatments, too. One classic study of people with asthma found that the effects of both airway openers and constrictors were substantially greater when people were told the real effect of the drug than when they were falsely informed it would have the opposite effect. Moreover, experts we consulted say there's no research to show that mere confidence in alternative methods accounts for their benefits. On the contrary, unconventional therapies have helped even skeptics. And alternative techniques have been more effective than similar "sham" procedures, as in some studies comparing needle placement at real acupuncture points vs. random sites.

True or false: Hypnotherapy doesn't work for some people because they're inherently resistant to hypnosis.
True. Almost everyone can achieve some form of light trance, such as daydreaming. However, reports suggest that 10 to 20 percent cannot enter the level of trance needed for hypnotic suggestion. In that state of relaxed attention, you're more responsive to suggestions for changing behavior, managing illness, and altering physiological processes. For example, one review of clinical trials concluded that self-hypnosis can reduce pregnant women's use of pain medication by about half. Other research shows that hypnotherapy lastingly relieves symptoms of irritable bowel syndrome in the vast majority of cases. Hypnosis seems to work best when you're highly motivated. If you've tried hypnotherapy unsuccessfully, you may have been unreceptive at the time rather than intrinsically resistant.

True or false: Acupuncture needles are painful when they're inserted.
False. The hair-thin needles cause little or no pain in most people. However, a needle may occasionally be inserted close to a nerve, causing a sharp twinge. And patients often feel a deep aching sensation; according to traditional Chinese medicine, that happens when the needle hits a channel of vital energy. Most people consider it "a good ache," although some find it unpleasant, says William M. Boggs, M.D., an acupuncturist and medical director of the Center for Integrative Medicine at the University of Maryland.

True or false: The vast majority of alternative techniques are virtually risk-free.
Mostly true. The alternative methods discussed here rarely cause substantial adverse effects--provided they're performed properly on appropriate patients by qualified practitioners. The one major exception: Avoid chiropractic manipulation of the neck, which in rare cases can trigger a stroke. In addition, take these common-sense precautions: Make sure your acupuncturist uses disposable needles sealed in a sterile package. Avoid massage if you have advanced osteoporosis, nerve or blood-vessel damage, or a clotting or bleeding disorder. Avoid chiropractic treatment of an injured or inflamed joint. And try to choose a therapist certified by a reputable group.

True or false: While tai chi can increase flexibility in healthy joints, it can't help joints damaged by rheumatoid arthritis.
False. Staying mobile is a major challenge for people with rheumatoid arthritis, since conventional high-impact exercise can cause further damage. Some evidence suggests that tai chi, which features gentle movements, may safely help those people. In two small, 10-week clinical trials, rheumatoid-arthritis patients who did tai chi once or twice a week improved their range of ankle, hip, and knee motion without harmful effects. Another small trial found it reduced pain and swelling. If you have rheumatoid arthritis and want to try tai chi, seek an instructor experienced in teaching people with arthritis. And ask for modifications if a movement or posture is uncomfortable.

True or false: Unconventional methods tend to interfere with standard cancer treatments.
False. Using an alternative therapy instead of a prescribed cancer treatment can have grave consequences--and certain herbs and supplements can reduce the effectiveness of chemotherapy drugs. But growing evidence indicates that many alternative methods may be safely used alongside standard ones. For example, clinical trials suggest that mind-body methods can quell stress and ease the pain of medical procedures. Massage therapy, now offered in many hospice programs and cancer centers, can lessen anxiety. And acupuncture can minimize the nausea caused by chemotherapy.

True or false: While meditation can boost mood, it's not useful if you're prone to depression.
False. To minimize the risk of relapse, doctors often advise clinically depressed people to keep taking medication indefinitely. Now a technique that combines mindfulness--an established relaxation method--and cognitive therapy, which tries to eliminate irrational, negative thoughts, may offer an alternative. Mindfulness-based cognitive therapy focuses on the self-critical thoughts that can help cause relapse. This eight-week training program teaches people not currently depressed to recognize negative thoughts and feelings as merely transient mental events. In two one-year studies of people who've had repeated bouts of depression, those who got the training were half as likely to relapse as those given only the usual care by their doctor.

True or false: Spinal manipulation is the best alternative treatment for low-back pain.
False. Manipulation is the most frequently chosen alternative treatment for back pain. But it's not necessarily the most effective. Studies of acupuncture, yoga, mind-body methods, massage, and spinal manipulation (usually done by chiropractors) suggest that all offer modest relief. In general they're safer than surgery or drugs and about as effective. In the absence of clear differences, the best therapy may be the one in which you're most confident. Confidence may make you more likely to stick with a treatment, or may yield extra benefits via the placebo effect.

True or false: Mind-body therapies may be useful for chronic illness, but not for surgery.
False. More and more hospitals are offering mind-body treatments to ease jitters before surgery and promote healing afterward. One review found "strong evidence" that preoperative use of relaxation, hypnosis, guided imagery, and similar methods can reduce pain and speed recovery. Other research indicates that such techniques before surgery--and sometimes during or after--can cut both the risk of postoperative complications and the use of pain medication.

True or false: It's not worth telling doctors about alternative treatments since they'll probably be dismissive.
False. While some physicians may object to nontraditional methods, it's still essential to try communicating openly about how you're handling any significant physical or psychological problem. Indeed, it's wise to have your physician diagnose your symptoms before you seek other treatment. Your doctor may tell you that the treatment you're considering is ill-suited for your condition or must be modified to avoid harm. The more your physician understands your approach to health, the better the two of you can work together. Such communication is actually common among Consumer Reports readers, according to a survey that included nearly 17,000 people who had recently used a nonconventional therapy. Almost 75 percent told their physicians about the treatment--and one-fourth said the alternative had been their doctor's idea. If your doctor persistently disparages alternative treatments that you think may help, offer to provide supporting evidence if possible. If that doesn't help and the conflict truly bothers you, consider seeking a different doctor.