Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?

Abstract

BackgroundAlthough back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies.MethodsWe identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months) of 70% of the patients with such diagnoses and all eligible respondents were interviewed.ResultsExcept for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5–16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option.ConclusionsMost patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional studies evaluating their effectiveness and suggests that researchers conducting clinical trials of these therapies may not have difficulties recruiting patients.

Non-Pharmacological Therapies in Pain Management

“…In a study conducted with the participation of 31.044 adults in United States, Barnes et al (2004) determined that the usage rate of the complementary methods for the last year has been 36% and back pain and lumbago come first with 16.8% and neck pain comes third with 6.6% in terms of usage reasons of the complementary methods . Sherman et al (2004) have stated that 24% of the patients with chronic lumbago used massage therapy.…”

The Use of Complementary and Integrative Health Practices in Disc Herniation Patients

“…'nın yapmış olduğu çalışmada disk hernili hastaların %15.2'sinin, Kıyak ve ark. tarafından yapılan çalışmada ise disk hernili hastaların sadece %5.1'inin TİSU olarak masajı tercih ettiği saptanmıştır [13,[21][22][23].…”

“…Bulgumuza benzer şekilde aynı konuda yapılmış diğer çalışmalarda da hastaların sosyo-demografik özellikleri ile TİSU kullanımı arasında anlamlı bir ilişki bulunmamıştır [13,22].…”

Massage Therapy: Intervention Frequency and Cost Survey (IFACS) Data with Policy Implications for Nonpharmacologic Treatment of Chronic Pain

“…Those few that have asked participants about their willingness to pay for massage therapy have shown conflicting results. For instance, chronic low back pain patients in the U.S. indicated that they would only be willing to receive massage therapy if they did not have to pay out of pocket while questionnaires completed in the UK indicated that 76% of 162 cancer patients were willing to pay out of pocket for massage therapy [32]. In both studies, potential out of pocket amounts were not specified.…”