TY - JOUR
T1 - Use of Complementary Health Approaches for Chronic Low-Back Pain
T2 - A Pain Research Registry-Based Study
AU - Licciardone, John C.
AU - Pandya, Vishruti
N1 - Funding Information:
This study was supported, in part, by the Osteopathic Heritage Foundation. This sponsor did not have a role in the design of the registry; the collection, analysis, or interpretation of data; or the writing or approval of the manuscript.
Publisher Copyright:
© Copyright 2020, Mary Ann Liebert, Inc., publishers 2020.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Objectives: To measure the use of complementary health approaches (CHAs) recommended in recent clinical practice guidelines relating to low-back pain, multivariate factors associated with their use, and clinical outcomes of CHA users and nonusers. Design: Observational cross-sectional study. Settings/Location: The Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation. Subjects: A total of 568 patients with chronic low-back pain. Interventions: Massage therapy, spinal manipulation, yoga, and acupuncture. Outcome measures: The numerical rating scale for low-back pain intensity, Roland-Morris Disability Questionnaire for back-related disability, and the Patient-Reported Outcomes Measurement Information System with 29 items for quality-of-life deficits relating to sleep disturbance, pain interference with activities, anxiety, depression, and low energy/fatigue. Results: The distribution of the number of different CHAs used by patients for low-back pain was as follows: 0, 179 (31.5%); 1, 139 (24.5%); 2, 160 (28.2%); 3, 70 (12.3%); and 4, 20 (3.5%). The numbers of patients using the specific CHAs were as follows: massage therapy, 271 (47.7%); spinal manipulation, 238 (41.9%); yoga, 144 (25.4%); and acupuncture, 96 (16.9%). Opioids had been used for low-back pain by 415 (73.1%) patients. Higher levels of education and higher pain self-efficacy scores were associated with greater use of any CHA, whereas increasing age and being Black were associated with lesser use of any CHA. Any CHA use was associated with lesser low-back pain intensity and lesser back-related disability. Patients who used massage therapy reported better clinical outcomes across all three dimensions. Patient pain self-efficacy also enhanced the effect of CHA use. Conclusions: The use of CHAs relative to opioids for low-back pain was inconsistent with recommendations from recent clinical practice guidelines despite clinical benefits with CHA use in this study. More research is needed on ways to improve the uptake of CHAs recommended for low-back pain, particularly among older and Black patients.
AB - Objectives: To measure the use of complementary health approaches (CHAs) recommended in recent clinical practice guidelines relating to low-back pain, multivariate factors associated with their use, and clinical outcomes of CHA users and nonusers. Design: Observational cross-sectional study. Settings/Location: The Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation. Subjects: A total of 568 patients with chronic low-back pain. Interventions: Massage therapy, spinal manipulation, yoga, and acupuncture. Outcome measures: The numerical rating scale for low-back pain intensity, Roland-Morris Disability Questionnaire for back-related disability, and the Patient-Reported Outcomes Measurement Information System with 29 items for quality-of-life deficits relating to sleep disturbance, pain interference with activities, anxiety, depression, and low energy/fatigue. Results: The distribution of the number of different CHAs used by patients for low-back pain was as follows: 0, 179 (31.5%); 1, 139 (24.5%); 2, 160 (28.2%); 3, 70 (12.3%); and 4, 20 (3.5%). The numbers of patients using the specific CHAs were as follows: massage therapy, 271 (47.7%); spinal manipulation, 238 (41.9%); yoga, 144 (25.4%); and acupuncture, 96 (16.9%). Opioids had been used for low-back pain by 415 (73.1%) patients. Higher levels of education and higher pain self-efficacy scores were associated with greater use of any CHA, whereas increasing age and being Black were associated with lesser use of any CHA. Any CHA use was associated with lesser low-back pain intensity and lesser back-related disability. Patients who used massage therapy reported better clinical outcomes across all three dimensions. Patient pain self-efficacy also enhanced the effect of CHA use. Conclusions: The use of CHAs relative to opioids for low-back pain was inconsistent with recommendations from recent clinical practice guidelines despite clinical benefits with CHA use in this study. More research is needed on ways to improve the uptake of CHAs recommended for low-back pain, particularly among older and Black patients.
KW - chronic low-back pain
KW - complementary health approaches
KW - nonpharmacologic therapy
KW - pain research registry
KW - physical functioning
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85084696077&partnerID=8YFLogxK
U2 - 10.1089/acm.2019.0448
DO - 10.1089/acm.2019.0448
M3 - Article
C2 - 32167785
AN - SCOPUS:85084696077
SN - 1075-5535
VL - 26
SP - 369
EP - 375
JO - Journal of Alternative and Complementary Medicine
JF - Journal of Alternative and Complementary Medicine
IS - 5
ER -