It is likely that the beneficial effects of CAM are mainly due to (1) reduction of stress responses (anti-stress effects) and (2) reduction of pain pathway (anti-nociceptive effects). Mind–body therapies may promote these effects via stimulating the brain activity (especially, prefrontal cortex; PFC and anterior cingulate cortex; ACC) and its networking, while manual therapies may promote these effects via stimulating somatosensory activation.
Both pathways finally activate the release of opioids and oxytocin (OXT) from the periaqueductal gray (PAG) and paraventricular nucleus (PVN), respectively. Released opioids and OXT mediate anti-nociceptive effects and anti-stress effects.
Thus, mind-body therapies may utilize PFC and ACC activation to stimulate PAG and OXT (top-down pathway), while manual therapies may utilize somatosensory activation to stimulate PAG and OXT (bottom-up pathway). In concert with both pathways, CAM is effective in various diseases associated with stress and pain.
In addition, CAM can regulate autonomic nervous system through both pathways. The enhancement of parasympathetic activity is beneficial for GI diseases and cardiovascular diseases.