Medical meditation? Clinical yoga? Alternative therapies are becoming mainstream.

The doctor is in. The yogi too.

There is a sharp shift in health care as more than a third of American adults now supplement or replace regular medical care with acupuncture, meditation, yoga and other therapies long considered alternative.

In 2022, 37 percent of adult pain patients used non-traditional medical care, a marked increase from 19 percent in 2002. research published this week in JAMA. The change has been driven by increasing insurance reimbursement for clinical alternatives, more scientific evidence of their effectiveness and increasing acceptance among patients.

“It has become part of the culture of the United States,” said Richard Nahin, lead author of the paper and an epidemiologist at the National Center of Complementary and Integrative Health, a division of the National Institutes of Health. “We're talking about using it for general wellness, stress management use, sleep, energy and immune health.”

And for pain relief. The use of yoga to manage pain increased from 11 percent in 2002 to 29 percent in 2022, an increase that Dr. Nahin partly reflected patients' efforts to find alternatives to opiates, and the influence of media and social media.

“It's so much in the public domain,” he said. “People hear acupuncture, meditation, yoga. They are starting to learn.”

The change also has consequences for doctors. Dr. Sean Mackey, chief of pain medicine at Stanford Medicine, said a growing body of research has validated alternative therapies, giving even traditional clinics like Stanford's more mind-body therapies and other non-pharmaceutical tools. He said acceptance of these ideas has grown especially among younger people, while patients from previous generations may have seen these options as too general.

“Our parents and grandparents looked at them and said, “What, are you kidding me?”?”

At the same time, Dr. Mackey that the therapies' growing prominence can be a “double-edged sword” because they don't always provide the relief that is marketed.

“My advice to people pursuing this is to do these things before a lawsuit,” he said. “But if it doesn't deliver long-term sustainable benefits, don't just keep doing it.”

The JAMA article drew its data from the 2002, 2012 and 2022 National Health Interview Survey, which was administered in person and by telephone. Researchers used the data to evaluate the use of seven complementary health care approaches: acupuncture, chiropractic care, guided imagery, massage therapy, meditation, naturopathy and yoga.

Meditation as a health therapy has risen sharply, from about 7.5 percent two decades earlier to about 17 percent of American adults in 2022. Dr. Nihan said the low cost was a factor: “How much does it cost to do meditation and yoga?” Such activities vary widely in price depending on whether they are done at home or in the classroom.

For some people, the alternatives seem superior. Jee Kim started the path of traditional medicine in 2022 when he was struggling with insomnia and anxiety due to a divorce. His doctor in Boulder, Colorado, prescribed medications that Mr. Kim initially used it, but it turned out to have intolerable side effects.

“I started taking yoga and meditation seriously,” he said, and eventually found a better solution for them. “I tried the pharmaceutical route, but I wanted tools I could come back to. I knew this wouldn't be my last difficult life transition.”

Mr. Kim, 49, a political consultant and former college tennis player who still avidly plays, also says yoga helps prevent injuries, so much so that he has become an occasional yoga instructor himself. “It is a pillar of my physical and mental health, including at work,” he said.

Dr. Jennifer Rhodes, a psychiatrist in Boulder who specializes in treating women undergoing hormonal changes, said that a “majority of my patients use additional interventions, such as those for stress management,” referring to the therapies in the study.

She said she embraced the concept, but cautioned that medications can also be crucial.

“Do acupuncture and massage,” she said. “But it's not fair to ask someone who is severely depressed or anxious and not functioning to hire someone until they can calm their nervous system.”