Japan – Complementary and Alternative Medicine

What types of complementary and alternative medicine are available in Japan?

Kampo herbal medicine, acupuncture, moxibustion, massage, and dietary therapies have all featured in Japanese healthcare since at least the early Edo period in the 17th century, and they remain deeply woven into everyday health practice. These therapies are the ones you will encounter most frequently, and in many ways they function as an inseparable part of mainstream medicine rather than as supplementary or fringe options.

Population-based internet surveys on CAM use among Japanese adults have consistently identified Kampo preparations and dietary supplements as the most widely consumed therapies. Kampo — a distinctly Japanese tradition of herbal medicine that evolved from classical Chinese medicine over many centuries — is prescribed by licensed medical doctors and dispensed in hospitals and clinics nationwide, placing it in a far more central role than herbal medicine occupies in the healthcare systems of most other countries.

Japan occupies a genuinely unusual position as a nation in which cutting-edge Western medicine and time-honoured Asian healing traditions operate side by side. Alongside Kampo, an extensive network of acupuncture and moxibustion clinics serves patients across the country, and massage — encompassing shiatsu and anma traditions — is a fixture in cities and provincial towns alike. These three therapy categories operate under their own national licensing structure, giving them a status much closer to that of allied health professions than to unproven alternatives.

Chiropractic and osteopathy, which command significant followings in various other countries, are not formally authorised by the Japanese government, yet both are practised in reality — especially in major centres such as Tokyo and Osaka, where internationally trained clinicians have set up practices. A related but distinctly Japanese manual therapy, seitai (manipulation of the spine and musculoskeletal system), is also widely offered, though it similarly operates without formal government licensing.

Homeopathy is a niche pursuit in Japan compared with much of Europe. Homeopathic products can be tracked down in specialist health retailers, and a handful of practitioners do offer consultations, but it commands nothing like the following it has elsewhere. Naturopathy, Ayurveda, and aromatherapy exist in a similar fashion — present but not institutionalised in any meaningful way. Yoga and mindfulness-based disciplines are gaining momentum, particularly among urban working populations, while qigong also has a following. A small segment of the medical profession incorporates additional alternative modalities including aromatherapy, homeopathy, health spa therapies, Ayurveda, hypnosis, flower therapy, and art therapy into their work.

The government formally recognises Judo-Orthopedics as a distinct paramedical category. Known as judo-seifukushi, licensed judo therapists treat fractures, dislocations, and sprains — a uniquely Japanese class of regulated manual practitioner with roots stretching back through the martial arts tradition. Their clinics, called seikotsuin, can be found across the country and are frequently covered by insurance for injuries.

Is complementary and alternative medicine regulated in Japan?

The Ministry of Health, Labour and Welfare (MHLW) exercises firm control over integrated medicine in Japan: it approves traditional herbal preparations and acupuncture needles, and requires practitioners to hold valid licences. This statutory framework applies, however, only to a defined set of therapies — principally acupuncture, moxibustion, anma-massage-shiatsu, and approved Kampo formulations. The great majority of other CAM practices conducted in Japan function without equivalent governmental oversight.

Those seeking an acupuncture or moxibustion licence must have completed studies at an MHLW-recognised acupuncture and moxibustion school or an approved university programme. The licence is personal and practice-specific. Candidates must also pass a national examination conducted under the auspices of the MHLW and administered by the Foundation for Training and Licensing Examination in Anma Massage-Acupressure, Acupuncture, and Moxibustion. This nationally standardised examination overseen by the health ministry bears a resemblance to the statutory registration frameworks that countries such as the UK apply to osteopathy or physiotherapy, rather than functioning as a purely voluntary arrangement.

Candidates for examination must either satisfy university entry requirements or have completed no fewer than three years of recognised education and training in the knowledge and skills pertaining to anma-massage-acupressure, acupuncture, and moxibustion at a vocationally approved institution. This three-year minimum training standard is broadly in line with the educational thresholds for acupuncture registration found in countries such as Australia and Canada.

Kampo medicine falls under Ministry of Health, Labour and Welfare regulation and is routinely applied in clinical settings. Kampo formulations must satisfy the quality criteria laid down in the Japanese Pharmacopoeia. Ethical Kampo preparations are prescribed within general practice by physicians under the National Health Insurance reimbursement scheme, while over-the-counter Kampo products are available for self-medication without a prescription.

The Japanese government does not regulate chiropractic practice. The Japan Chiropractic Register (JCR), which was established in 2008, is an independent body that registers chiropractors working in Japan. Eligibility requires the completion of an educational programme that meets WHO guidelines along with passing the JCR registration assessment. The JCR makes its registrant list publicly accessible and submits it to the MHLW to assist members of the public in identifying chiropractors who meet established safety standards. This constitutes a voluntary self-regulation model — the professional title “chiropractor” carries no statutory protection in Japan, meaning anyone may technically use it without formal qualification. Osteopathy is similarly without a government licensing framework.

Homeopathy, naturopathy, aromatherapy, Ayurveda, and the majority of other Western-imported CAM therapies are entirely unregulated in Japan, with no formal licensing conditions, no protected titles, and no designated government oversight body. For the most current licensing requirements, consult the Ministry of Health, Labour and Welfare (MHLW) website directly, as regulations may be subject to amendment.

Is CAM covered by health insurance or the public healthcare system in Japan?

Japan’s national health insurance scheme extends unusually broad coverage to certain traditional therapies by comparison with public health systems in most other nations. The degree of coverage varies considerably, however, depending on the particular therapy and the treatment context.

A landmark development came in 1976, when Kampo formulations were formally incorporated into Japan’s National Health Insurance scheme, cementing their status within modern medical practice. This integration made Kampo preparations accessible to a wide patient population at a genuinely manageable cost. Currently 148 Kampo formulas are covered under the national health insurance (as of 2019; consult the MHLW for the current list). When a licensed physician prescribes these formulas, patients pay only their standard co-payment — typically 30% for working-age adults — rendering Kampo genuinely affordable through the public system.

Acupuncture, moxibustion, massage, and related treatments may qualify for health insurance benefits, though specific conditions must be satisfied. Benefits for medical care expenses are generally available only for defined conditions, and only in chronic cases where an insurance doctor determines that no other appropriate treatment is available. A patient receiving acupuncture or moxibustion under a letter of approval from an insurance doctor must be reassessed and obtain a further letter of approval if treatment continues beyond six months.

The insurance association provides benefits for medical care expenses through a reimbursement arrangement. Patients pay the full amount at the point of treatment and subsequently apply to their Health Insurance Association for reimbursement, submitting all required documentation. This reimbursement model differs meaningfully from direct billing: it places the administrative burden on the patient, which can pose a practical challenge for those not yet confident navigating Japanese-language paperwork.

Chiropractic care has gained considerable community acceptance over the years, notwithstanding its exclusion from national health insurance coverage. Certain overseas private insurers will reimburse chiropractic treatment. Homeopathy, naturopathy, osteopathy, and most other unregulated therapies are not reimbursable under the public system. Always confirm current coverage conditions directly with your insurer or the MHLW, as policies and approved therapy lists are liable to change.

How much does complementary and alternative medicine cost in Japan?

CAM pricing in Japan varies substantially according to the therapy, practitioner, and location. Metropolitan areas — Tokyo in particular — typically attract higher fees, and practices oriented toward international clientele may charge a premium on top of that. All figures below are approximate and current as of 2024; confirm pricing directly with individual practitioners or relevant professional associations before booking.

Acupuncture is almost never covered by health insurance and is treated as an elective expense. Fees vary notably by region and practitioner but generally fall in the range of approximately USD 26 (¥2,500) to USD 63 (¥6,000) per session. In practice, clinics in Tokyo and other major cities often charge ¥4,000–¥8,000 per session as of 2024, with some specialist or internationally focused practices charging considerably more.

A survey of acupuncture, moxibustion, and massage clinics found that the mean treatment fee across all practitioners was approximately ¥3,552 per session at the time of the survey. This average spans a broad range of clinic types and should be regarded only as a rough benchmark. Massage — whether anma, shiatsu, or Western-style — tends to be priced similarly, with many standalone massage establishments offering 30-minute sessions from around ¥3,000.

Kampo consultations prescribed through a conventional medical clinic are subject to national health insurance coverage, meaning your co-payment will typically represent only a fraction of the full cost. Over-the-counter Kampo preparations bought at pharmacies without a prescription range from a few hundred yen for a basic formula to several thousand yen per month for premium products.

Chiropractic appointments in Japan typically cost in the region of ¥5,000 to ¥15,000 or more per visit as of 2024, with internationally trained practitioners at specialist clinics commonly at the upper end of that range. Osteopathy is priced comparably. Homeopathy consultations, where they can be found, vary widely in cost. As fees change and differ considerably between practitioners, always contact clinics directly for current schedules, and consider reaching out to the Japanese Association of Chiropractors (JAC) or the relevant professional association for further guidance.

How do I find a qualified CAM practitioner in Japan?

Locating a qualified CAM practitioner in Japan differs markedly by therapy type, given the uneven regulatory landscape. For therapies that carry a government licence, the path is relatively straightforward; for unregulated modalities, thorough due diligence is essential.

1. For acupuncture and moxibustion: The Japan Society of Acupuncture and Moxibustion (JSAM) is the country’s foremost academic body for these disciplines. Visit jsam.jp for further information. You can also verify a practitioner’s national licence through the Foundation for Training and Licensing Examination in Anma Massage-Acupressure, Acupuncture, and Moxibustion (AHAKI). Always ask any acupuncturist to produce their MHLW-issued licence certificate.
2. For Kampo: The most reliable route is to obtain Kampo through a licensed medical doctor (ishi) at a hospital or clinic, where prescriptions fall under national health insurance coverage. The Japan Society of Oriental Medicine (JSOM) maintains information regarding Kampo practice and educational standards.
3. For chiropractic: Contact the Japanese Association of Chiropractors (JAC), a WHO-affiliated WFC national member organisation, which provides details on certified clinics including those with practitioners who work in other languages. Visit jac-chiro.org. The Japan Chiropractic Register (JCR) also maintains a publicly accessible list of practitioners who have satisfied WHO-standard educational requirements.
4. For osteopathy: No government register exists. Seek practitioners who trained at accredited osteopathic institutions in countries with statutory regulation — such as France, the UK, or Australia. Clinics in major cities frequently publish their practitioners’ international qualifications on their websites.
5. General searches: Hospital international liaison offices and expat networks — including platforms such as InterNations or local expat groups on social media — can yield peer-reviewed recommendations. A referral from your GP or a hospital outpatient department is also a dependable starting point, particularly for Kampo and acupuncture.

When selecting any unregulated CAM practitioner in Japan, be alert to warning signs: clinicians who guarantee cures, who pressure patients into purchasing costly product packages, or who encourage discontinuation of prescribed medication. Because chiropractic is not government-regulated, incidents and complaints arising from treatment by practitioners who do not adhere to a rigorous code of ethics are periodically reported. Consumer protection complaints may be directed to the National Consumer Affairs Center of Japan (NCAC).

Are there traditional or indigenous medicine systems practised in Japan?

Japan’s most significant indigenous medical tradition is Kampo (漢方), a system of herbal medicine that arrived from China but was refined into a distinctly Japanese discipline over many centuries. Originating in classical Chinese medicine, Kampo developed its own identity in Japan over time and is today widely incorporated into everyday clinical practice by physicians. Remarkably among traditional medicine systems globally, Kampo has been woven directly into the national healthcare infrastructure rather than relegated to its margins.

More than 80% of Japanese physicians include Kampo in their practice, frequently alongside Western pharmaceutical treatments, reflecting its genuinely complementary function in clinical care. This extensive uptake may in part be attributed to a curriculum reform introduced in 2001 requiring all Japanese medical schools to include a minimum Kampo medicine component in their teaching. Consequently, patients in Japan can receive Kampo prescriptions from an ordinary GP or hospital doctor as part of standard care — a degree of integration that has no close equivalent in most Western healthcare systems.

Acupuncture, moxibustion, massage, and dietary medicine have been employed since the early Edo period as what practitioners regarded as legitimate medicine in their own right, rather than as adjuncts to a separate mainstream system. Moxibustion (okyu), which involves burning dried mugwort near or directly on the skin to activate acupoints, is particularly embedded in Japanese culture and is commonly administered alongside acupuncture within the same clinical appointment.

Judo has commanded popular devotion in Japan since ancient times. Because fractures, dislocations, and similar injuries were common among judo practitioners, specialised orthopaedic techniques were developed by those within the martial arts community over hundreds of years. The government accordingly recognises Judo-Orthopedics as a distinct paramedical profession. This makes judo-seifukushi — licensed judo therapists — a uniquely Japanese category of regulated manual practitioner that occupies a position somewhere between physiotherapy and traditional manual medicine.

Folk wellness traditions such as onsen (hot spring) bathing and various forms of mineral-water therapy also carry profound cultural significance in Japan and are widely embraced for relaxation and general wellbeing, even though they are not recognised as medical treatments in any formal regulatory sense. Shinrin-yoku (forest bathing) has attracted international attention as a Japanese preventive health concept and is actively endorsed by the government as part of its public health strategy.

What should expats know about using CAM alongside conventional medicine in Japan?

Japan occupies a distinctive position as a country in which advanced Western medicine and established Asian healing traditions coexist on equal terms, and this dynamic shapes how both doctors and patients approach combined treatment approaches. For expats, this means the environment for raising CAM with a conventional doctor tends to be more receptive than in many other countries — though clear communication remains essential.

Given that over 80% of Japanese physicians incorporate Kampo into their practice, your GP or hospital doctor is likely to be familiar with herbal formulations and may even prescribe them in tandem with conventional medications. That familiarity with Kampo does not necessarily carry over to other CAM modalities such as chiropractic, homeopathy, or Western herbalism, about which your doctor may have limited knowledge.

Herb-drug interactions are a genuine safety consideration. Certain herbs — St. John’s wort among them — can interact with pharmaceutical drugs, and the fact that such herbs are classified as foods in many jurisdictions creates additional risk of patients not disclosing their use. Always tell your prescribing doctor about any Kampo formulas, dietary supplements, or herbal products you are consuming. This is particularly important if you are taking anticoagulants, immunosuppressants, or oncology medications. The Pharmaceuticals and Medical Devices Agency (PMDA) publishes guidance on drug interactions, including those involving traditional medicinal products.

Integrative medicine facilities — which formally combine conventional and traditional treatments under one roof — do operate in Japan, especially within university hospitals and major regional medical centres. These settings are more common than their equivalents in most other countries, a reflection of Japan’s long history of parallel practice. Language, however, can present a significant barrier for those not yet fluent in Japanese: many integrative clinics function primarily in Japanese, and treatment information along with informed consent documents is often unavailable in other languages.

For practical safety information, consult the Ministry of Health, Labour and Welfare (MHLW) website for official positions on specific therapies. When purchasing herbal or supplement products, verify whether they carry MHLW approval or are listed in the Japanese Pharmacopoeia. Exercise caution regarding products marketed through multi-level sales networks or online retailers without clear regulatory credentials — consumer protection concerns relating to unlicensed health products are periodically flagged by the National Consumer Affairs Center of Japan (NCAC).

Frequently asked questions

Can I find CAM practitioners in Japan who speak languages other than Japanese?

Yes, particularly in large cities such as Tokyo, Osaka, and Yokohama. The Japanese Association of Chiropractors (JAC) can assist in identifying practitioners who conduct consultations in other languages. A number of osteopathy and acupuncture clinics in major cities actively cater to international patients. Expat community networks and hospital international liaison offices are also valuable channels for locating practitioners with multilingual capabilities.

Is chiropractic legal in Japan?

Both chiropractic and osteopathy services are quite popular in Japan. Chiropractic is not prohibited, but neither is it formally regulated or licensed by the Japanese government. This means that while qualified, internationally trained chiropractors can practise legally in Japan, no governmental mechanism exists to prevent unqualified individuals from offering comparable services under the same name. Always verify a practitioner’s credentials and confirm whether they appear on the Japan Chiropractic Register (JCR).

How do I check a CAM practitioner’s credentials in Japan?

For licensed therapies (acupuncture, moxibustion, anma-massage-shiatsu), ask to see the practitioner’s MHLW-issued national licence. For Kampo, confirm that the prescribing doctor holds a standard medical licence (ishi menkyo). For chiropractic, check the Japan Chiropractic Register (JCR) or verify JAC membership. For other unregulated therapies, look for internationally recognised qualifications earned at accredited institutions in countries with statutory regulation.

Is Kampo safe for expats to use?

When prescribed by a licensed physician and dispensed through the national health insurance system, Kampo is held to the same quality standards as pharmaceutical medicines and is generally regarded as safe. As with any medication, potential side effects and interactions exist. Inform your doctor of every medication and supplement you are taking. In some instances, serious adverse effects — including liver damage — have been reported with certain Kampo formulas, which underlines the importance of professional medical supervision.

How is CAM viewed within Japanese healthcare culture?

Both conventional and traditional medicine have been considered integral elements of Japanese healthcare since the mid-nineteenth century and have been treated as fully integrated since the 1970s. Kampo carries no cultural stigma whatsoever in Japan — it is as routine as receiving a pharmaceutical prescription. Acupuncture and massage are broadly accepted by the general population. Western-originated therapies such as homeopathy or naturopathy are less culturally familiar but are becoming increasingly available in urban settings.

Do I need to enrol in national health insurance to access Kampo?

Yes. To receive Kampo formulas at the subsidised national health insurance rate, you must be enrolled in Japan’s national health insurance system — either National Health Insurance (Kokumin Kenko Hoken) or the employee-based Shakai Hoken. All residents of Japan, including foreign nationals, are required to enrol. Without insurance, the full cost of Kampo prescriptions falls entirely on the patient. Consult the MHLW or your municipal office for current enrolment requirements.

Are there any CAM therapies that are banned or restricted in Japan?

No mainstream CAM therapies are outright banned. However, certain products — including particular herbal ingredients and dietary supplements — may be classified as pharmaceuticals under Japanese law and are therefore ineligible for sale as ordinary foods or supplements. Dong quai, for example, is sold as a food supplement in some countries but is classified as a medicine in Japan. Always verify the regulatory status of any product before bringing it into Japan or purchasing it domestically. The PMDA and the MHLW publish guidance on the classification of specific substances.

Are there integrative medicine clinics in Japan where I can receive both conventional and CAM treatment?

Yes. Integrative medicine departments and clinics that combine conventional Western medicine with Kampo, acupuncture, or other modalities operate at a number of university hospitals and specialist centres across Japan. The Society for Integrative Medicine Japan promotes and coordinates integrative practice throughout the country. Most of these facilities operate primarily in Japanese, however, so arranging an interpreter or selecting a clinic with multilingual staff is advisable for those not yet proficient in the language.