Consultations with complementary and alternative medicine practitioners amongst wider care options for back pain: a study of a nationally representative sample of 1,310 Australian women aged 60–65 years

Abstract

Back pain is a significant health service issue in Australia and internationally. Back pain sufferers can draw upon a range of health care providers including complementary and alternative medicine (CAM) practitioners. Women are higher users of health services than men and tend to use CAM frequently for musculoskeletal conditions. However, there remain important gaps in our understanding of women's consultation patterns with CAM practitioners for back pain. The objective of this study is to examine the prevalence of use and characteristics of women who use CAM practitioners for back pain. The method used was a survey of a nationally representative sample of women aged 60-65 years from the Australian Longitudinal Study on Women's Health. Women consulted a massage therapist (44.1 %, n = 578) and a chiropractor (37.3 %, n = 488) more than other CAM practitioners for their back pain. Consultations with a chiropractor for back pain were lower for women who consulted a General Practitioner (GP) (OR, 0.56; 95 % CI 0.41, 0.76) or a physiotherapist (OR, 0.53; 95 % CI 0.39, 0.72) than for those who did not consult a GP or a physiotherapist. CAM practitioner consultations for back pain were greater for women who visited a pharmacist (OR, 1.99; 95 % CI 1.23, 3.32) than for women who did not visit a pharmacist. There is substantial use of CAM practitioners alongside conventional practitioners amongst women for back pain, and there is a need to provide detailed examination of the communication between patients and their providers as well as across the diverse range of health professionals involved in back pain care.

An integrative review of complementary and alternative medicine use for back pain: a focus on prevalence, reasons for use, influential factors, self-perceived effectiveness, and communication

“…The majority of large sample-sized population studies were from North America (n58) and Australia (n57), and Australia had the largest number of large-sized population studies specific to back pain (n56). Of these Australian back pain-focused studies, five articles reported analyses from a National Longitudinal Study on Women's Health [26,47,50,58,59]. The analysis of the articles has been grouped into five themes, and Table 5 provides an overview of the important findings.…”

“…Only four studies had small sample sizes and were conducted in clinical settings [60,61,66,67]. Of the large sample-sized studies, 8 were conducted in clinical settings [30,43,[62][63][64][65]68,69] and the remaining 18 were population-based studies [26,29,42,44,45,[47][48][49][50][51][52][53][54][55][56][57][58][59].…”

“…Among these, five studies drawing on nationally representative samples focused on consultations with one or more CAM practitioner types for back pain reporting prevalences ranging from 37% to 76.4% (mean: 55.2%; median 53.6%) [26,47,50,51,58]. One Australian study examining women with back pain reported the prevalence of self-prescribed CAM use as 75.2% [59].…”

“…Among a range of CAM modalities, acupuncture, chiropractic, osteopathy, and massage therapy were commonly used for back pain. The use of acupuncture for back pain was reported in a number of articles included in the review (in the range of 6%-60.2%, mean: 27.4%; median: 13.3%) [29,30,47,50,56,58,[60][61][62]. The use of acupuncture for back pain showed wide variation between population-based studies (ranging from 6% to 60.2%, mean: 22.4%; median: 13.3%) [29,47,50,56,58] and studies conducted within clinical settings (ranging from 11% to 59%, mean: 33.6%; median: 32.2%) [30,[60][61][62].…”

“…The prevalence rates of overall CAM use for back pain reported in the articles drawing on large sample sizes ranged from 6% to 76.4% (mean: 34.2%; median: 29%) [26,42,44,47,[49][50][51][52]58,59]. Among these, five studies drawing on nationally representative samples focused on consultations with one or more CAM practitioner types for back pain reporting prevalences ranging from 37% to 76.4% (mean: 55.2%; median 53.6%) [26,47,50,51,58].…”