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Percieved Benefits of Complementary Alternative Medicine (CAM) for Back Pain

This study correlates with my experience. The vast majoriyt of our patients perceived good results with natural methods and liked them over traditional methods. Please read on, click on the lowest link for the complete study. Dr Cliff

Benefit of Complementary and

Alternative Medicine (CAM) for Back Pain:

A National Survey

Anup K. Kanodia, MD, MPH, Anna T. R. Legedza, ScD, Roger B. Davis, ScD, David M. Eisenberg, MD, and Russell S. Phillips, MD Background: Complementary and alternative medicine (CAM) is commonly used to treat back pain, butlittle is known about factors associated with improvement. Methods: We used data from the 2002 National Health Interview Survey to examine the associationsbetween the perceived helpfulness of various CAM therapies for back pain. Results: Approximately 6% of the US population used CAM to treat their back pain in 2002. Sixty percentof respondents who used CAM for back pain perceived a “great deal” of benefit. Using multivariable logistic regression, the factor associated with perceived benefit from CAM modalities was reporting that a reason for using CAM was that “conventional medical treatment would not help” (odds ratio [OR], 1.46; 95% CI, 1.14 –1.86). The 2 factors associated with less perceived benefit from CAM modalities were fair to poor self-reported health status (OR, 0.58; 95% CI, 0.41– 0.82) and referral by a conventional medical practitioner for CAM (OR, 0.7; 95% CI, 0.54–0.92). Using chiropractic as a reference, massage (OR, 0.62; 95% CI, 0.46–0.83), relaxation techniques (OR, 0.25; 95% CI, 0.14–0.45), and herbal therapy (OR, 0.3; 95% CI, 0.19–0.46) were all associated with less perceived benefit whereas those with similar perceived benefit included yoga/tai chi/qi gong (OR, 0.71; 95% CI, 0.41–1.22) and acupuncture (OR, 0.71; 95% CI, 0.37–1.38). Conclusions: The majority of respondents who used CAM for back pain perceived benefit. Specificfactors and therapies associated with perceived benefit warrant further investigation. (J Am Board Fam Med 2010;23:354 –362.) Keywords: Primary Health Care, Chronic Disease, Complementary Medicine, Alternative Medicine, Back Pain, ChiropracticIn the United States, back pain affects between 15% and 30% of the population yearly and is the second leading reason for ambulatory care visits.1,2Back pain is the most common reason for complementary and alternative medicine (CAM) use in the United States, and patients with back pain have more office visits to CAM practitioners than to primary care physicians.3,4 In 2007 the AmericanCollege of Physicians and the American Pain Society published updated clinical guidelines for the diagnosis and treatment of lower back pain based on high-quality meta-analysis for acupuncture5;This article was externally peer reviewed. Submitted 5 December 2008; revised 3 September 2009;accepted 8 September 2009. From the Division for Research and Education in Complementaryand Integrative Medical Therapies, Harvard Medical School Osher Research Center, Boston (AKK, RBD, DME, RSP); the Department of Medicine, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (AKK, RBD, RSP); Vertex Pharmaceuticals, Cambridge (ATRL); and the Department of Medicine, Osher Clinical Center for Complementary and Integrative Medical Therapies, Brigham and Women’s Hospital, Boston (DME), MA. Funding: Support has been provided by an InstitutionalNational Research Service Award (T32AT00051-06) from the National Institutes of Health (AKK) and a Mid-Career Investigator Award (K24-AT000589) from the National Center for Complementary and Alternative Medicine, National Institutes of Health (RSP). See Related Commentary on Page 283. Prior presentation: A portion of this paper was presented atthe annual meeting of the Society of Teachers of Family Medicine, Chicago, IL, April 2007. Conflict of interest: none declared.Disclaimer: The contents of this manuscript are solely theresponsibility of the authors and do not necessarily represent the official views of the National Center for Complementary and Alternative Medicine, or the National Institutes of Health. Corresponding author: Anup Kanodia, MD, Division forResearch and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, 401 Park Drive, Suite 22-A West, Boston, MA 02215 (E-mail: [email protected]). 354 JABFM May–June 2010 Vol. 23 No. 3

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