Alternative Pain Management Common Among Patients With Musculoskeletal Pain

Deborah Brauser

October 14, 2016

Individuals with musculoskeletal pain use complementary health approaches nearly twice as much as those without this type of pain, according to a new report from the National Center for Health Statistics (NCHS).

Data from the National Health Interview Survey (NHIS) show that more than half of the adults in the United States had some type of musculoskeletal pain disorder in 2012, including lower back or neck pain, sciatica, and arthritic conditions.

Among the more than 34,000 adults who answered questions about complementary health approaches, almost 42% of those with a musculoskeletal pain disorder said they had used this type of pain strategy for any reason vs 24% of respondents without a pain disorder.

The most common approach by those with musculoskeletal pain was use of natural products, such as nonvitamin and nonmineral supplements, followed by practitioner-based strategies, including chiropractic and Alexander techniques.

Interestingly, only 14% of these patients reported using any complementary health approach specifically to treat their pain disorder. Still, among these individuals, the most common approach for treatment was the use of practitioner-based strategies.

The investigators, led by Tainya C. Clarke, PhD, from the NCHS, write that assessing which types of approaches are being used by this patient population can "better inform physician-patient dialogue and priority-setting efforts for clinical researchers."

The results may also be helpful "in implementing the 2016 National Pain Strategy, which lays out a plan for better addressing pain issues in the United States," they add.

Conventional Treatment "Lacking"

The researchers note that "conventional" treatment for this type of chronic pain, including surgery and nonsteroidal anti-inflammatory medications, and opioids "often lack long-term benefit or subject patients to other risks.

"Consequently, some persons with these conditions may seek alternative treatment options."

The investigators examined data from the 2012 NHIS, a household interview survey conducted continuously by the NCHS. The new report specifically describes the 34,525 adults who provided information on the survey's Adult Alternative Medicine supplement, regarding complementary health approaches they used during the previous year.

Twenty-three different complementary approaches were brought up and then placed into the following four groupings:

  • Natural products (including nonvitamins and special diets);

  • Practitioner-based approaches (including osteopathic manipulation, massage therapy, and Feldenkrais);

  • Mind and body approaches (including biofeedback, hypnosis, meditation, and yoga); and

  • Whole medical system (including acupuncture, homeopathy, naturopathy, and Ayurveda).

"Whole medical systems involve complete systems of theory and practice that have evolved independently from, or parallel to, conventional medicine," explain the researchers.

As shown in the table below, the responders with a musculoskeletal pain disorder used strategies falling into each of these complementary health categories for any reason significantly more often than those without such a disorder.

Table. Percentage Use of Complementary Health Categories for Any Reason

Approach With Any Musculoskeletal Pain Disorder (%) Without Any Musculoskeletal Pain (%)
Natural products 24.7 13.4
Practitioner-based 18.2 6.9
Mind and body 15.3 10.2
Whole medical system 5.3 2.5


When examining the types of musculoskeletal pain that the participants had, the investigators found that 50.6% of those with neck pain/problems used at least one type of complementary health approach for any reason, compared with the following:

  • 44.2% of those with nonarthritic joint pain or other joint conditions;

  • 43% with lower back pain (without sciatica);

  • 41.9% with sciatica;

  • 40.9% with arthritic conditions, such as gout and rheumatoid arthritis; and

  • 46.2% with other musculoskeletal problems.

The percentages were much smaller for patients who used any complementary health approach for treatment:

  • 11.2% of those with sciatica;

  • 10.3% of with lower back pain;

  • 9.2% with neck pain/problems;

  • 6.6% with arthritic conditions;

  • 6.4% with nonarthritic joint pain or other conditions; and

  • 4.1% with other musculoskeletal problems.

In the overall group of patients with musculoskeletal problems, 9.7% used practitioner-based approaches for treatment compared with 3.1% who used natural products, 1.8% who used mind and body approaches, and just 0.7% who used a whole medical system approach.

In their summary, the investigators note that strengths of their data include the large sample size. Limitations include not knowing whether the various approaches were used before the responders had a musculoskeletal pain disorder, no information being collected on simultaneous treatment with conventional medicine, and the dependence on patient recall.

Still, "this report adds to evidence regarding the use of complementary approaches to treat or manage pain in the US population," they write.

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