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


METHODS
We 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.


RESULTS
Except 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.


CONCLUSIONS
Most 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.
Sherman
Karen J
KJ
Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA. Sherman.k@ghc.org
Cherkin
Daniel C
DC
Connelly
Maureen T
MT
Erro
Janet
J
Savetsky
Jacqueline B
JB
Davis
Roger B
RB
Eisenberg
David M
DM
D026881:Acupuncture; D000328:Adult; D000368:Aged; D001900:Boston; D002684:Chiropractic; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D000529:Complementary Therapies / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008405:Massage; D019122:Meditation; D008875:Middle Aged; D026441:Mind-Body Therapies; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data; D011159:Population Surveillance; D026302:Tai Ji; D014861:Washington