title: Complementary and Alternative Medicine Use by Children With Pain in the United States.
abstract: Chronic pain is reported by 15% to 25% of children. Growing evidence from clinical samples suggests that complementary and alternative medicine (CAM) therapies are desired by families and may benefit some children with pain conditions. The objective of this study was to provide estimates of CAM use by children with pain in the United States.
  
  
  
  We analyzed data from the 2012 National Health Interview Survey (NHIS) to estimate patterns, predictors, and perceived benefits of CAM use among children 4 to 17 years of age with and without painful conditions in the United States. We used chi-square tests to compare the prevalence rates of CAM use among children with pain to CAM use among children without pain. Multivariable logistic regression was used to examine factors associated with CAM use within the group of children with pain conditions.
  
  
  
  Parents reported that 26.6% of children had pain conditions (eg, headache, abdominal, musculoskeletal pain) in the past year; of these children, 21.3% used CAM. In contrast, only 8.1% of children without pain conditions used CAM (χ2, P < .001). CAM use among children with pain was associated with female sex (adjusted odds ratio [aOR] = 1.49, P = .005), higher income (aOR = 1.61, P = .027), and presence of 4+ comorbidities (aOR = 2.01, P = .013). Among children with pain who used CAM, the 2 most commonly used CAM modalities were biology-based therapies (47.3%) (eg, special diets and herbal supplements) and manipulative or body-based therapies (46.3%) (eg, chiropractic and massage).
  
  
  
  CAM is frequently used by children with pain in the United States, and many parents report benefits for their child's symptoms.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash. Electronic address: Cornelius.groenewald@seattlechildrens.org.
authors.forename: Cornelius B
authors.initials: CB
authors.lastname: Groenewald
authors.affiliation: Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Wash.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Beals-Erickson
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ralston-Wilson
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Rabbitts
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash; Department of Psychiatry, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Wash.
authors.forename: Tonya M
authors.initials: TM
authors.lastname: Palermo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D059350:Chronic Pain / Q000628:therapy*; D015897:Comorbidity; D000529:Complementary Therapies / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D010290:Parents / Q000523:psychology*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States
keywords: complementary and alternative medicine; integrative medicine; pain