Complementary and Alternative Medicine Use in the US Adult Low Back Pain Population. Global Advances in Health and Medicine January 2016; Vol. 5; No. 1; pp. 69-78
Neha Ghildayal, Pamela Jo Johnson, MPH, PhD, Roni L. Evans, DC, MS, PhD, and Mary Jo Kreitzer, PhD, RN.
The data for this article was from the 2012 National Health Interview Survey (NHIS), which is the most current nationally representative data available on CAM
health practices. Data was collected on 34,525 adults. “A major strength of this study was that it used a large, nationally representative survey of the US adult population with LBP and included a comprehensive list of CAM therapies.”
KEY POINTS FROM THIS STUDY:
1) “A key goal of healthcare for patients with chronic back pain is to maximize their functional status so that they are able to carry out activities of daily living.”
2) “Many people suffering from LBP have found conventional medical treatments to be ineffective and unreliable for treating their pain. Therefore, due to
dissatisfaction with conventional treatments for LBP, individuals suffering from LBP are increasingly turning to complementary and alternative medicine (CAM) to find relief.”
3) Low back pain (LBP):
• Costs the United States healthcare system about $100 billion a year.
• Resulting in over 150 million lost workdays per year and $16 billion annually
in lost productivity in the US.
• More than 80% of adults in the US will experience it at some point during
• Is a major cause of functional limitations and disability:
•• are 3 times more likely to have limited functional ability
•• are more than 4 times likely to experience serious psychological distress
• “People with back pain suffer from worse physical and mental health than
people without back pain.”
4) “A growing body of evidence supports the use of CAM for improving back pain outcomes, with back pain being the most common condition for which patients
5) “Overall, chiropractic manipulation was the most prevalent CAM therapy used within the LBP population.” [Important]
6) “The majority of respondents (58.1%) who used CAM in the past year forback pain perceived a ‘great deal’ of benefit.”
7) “For people with severe LBP, turning to CAM may seem a better alternative due to its more conservative, noninvasive nature as compared to more conventional medical treatments such as epidural steroid injections, surgeries, and prescriptive medications—all which may carry higher risks than CAM treatments.”
8) Also, “those with severe pain may have exhausted all other possibilities and may be looking for any possibility of relief” and as such seek CAM approaches.
9) People may also seek CAM because of it low associated treatment risks.
10) “CAM therapies are becoming an increasingly important component of care for people with LBP.”
11) Over 40% of the US population used some form of CAM in the past year, with higher use reported among those with back pain.
12) The most popular therapies used in the LBP population included herbal therapies, chiropractic manipulation, and massage.
13) “The majority of the LBP population used CAM specifically to treat back pain, and most adults who used CAM for back pain perceived a great deal of benefit.”
14) “CAM use appears to be an important and growing part of healthcare for the back pain population.”
Limitations from this study include that the authors did not distinguish between acute and chronic back pain patients, which would undoubtedly influence the
percentages of perceived benefits from the various approaches. Chiropractic remains the leader of outpatient management choices for CAM for LBP, with an extremely high patient satisfaction rate; yet only 15% of those with LBP are using chiropractic.
Surprisingly, acupuncture is only being used by 2% of those with low back pain. An important aspect of this study (mentioned but not quantified) is that all of the CAM approaches are extremely safe, with a very low risk of adverse occurrences. Lastly, a mentioned but underemphasized aspect of this study is that many who chose to use CAM do so because traditional approaches to the management of their back pain was ineffective.
[Most chiropractors do not consider chiropractic to be “alternative” or “complementary” to medical practice, but rather a scientifically proven, non-drug, and non-surgical approach to healthcare problems, including musculoskeletal pain].