title: The use of CAM and conventional treatments among primary care consulters with chronic musculoskeletal pain.
abstract: BACKGROUND
  Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM). Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be.
  
  
  METHODS
  
  
  
  OBJECTIVE
  To determine CAM use among patients with chronic musculoskeletal pain who have consulted about their pain in primary care.
  
  
  METHODS
  Face-to-face interview-based survey.
  
  
  METHODS
  Three general practices in North Staffordshire.
  
  
  METHODS
  Respondents to a population pain survey who had reported having musculoskeletal pain in the survey and who had consulted about their pain in primary care in the previous 12 months as well as consenting to further research and agreeing to an interview. Information was gathered about their pain and the use of all treatments for pain, including CAM, in the previous year.
  
  
  RESULTS
  138 interviews were completed. 116 participants (84%) had used at least one CAM treatment for pain in the previous year. 65% were current users of CAM. The ratio of over-the-counter CAM use to care from a CAM provider was 3:2. 111 participants (80%) had used conventional treatment. 95 (69%) were using a combination of CAM and conventional treatment. Glucosamine and fish oil were the most commonly used CAM treatments (38%, 35% respectively). Most CAM treatments were scored on average as being helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used.
  
  
  CONCLUSIONS
  We provide direct evidence that most primary care consulters with chronic musculoskeletal pain have used CAM in the previous year, usually in combination with conventional treatments. The high prevalence and wide range of users experiences of benefit and harm from CAM strengthen the argument for more research into this type of medicine to quantify benefit and assess safety. The observation that most users of conventional medicine also used CAM suggests a continuing need for more investigation of effective pain management in primary care.
authors.affiliation: Primary Care Musculoskeletal Research Centre, Keele University, Stoke on Trent, Staffordshire, UK. m.artus@cphc.keele.ac.uk
authors.forename: Majid
authors.initials: M
authors.lastname: Artus
authors.forename: Peter
authors.initials: P
authors.lastname: Croft
authors.forename: Martyn
authors.initials: M
authors.lastname: Lewis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D010146:Pain / Q000209:etiology / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom