Use of complementary alternative medicine for low back pain consulting in general practice: a cohort study
1 Dpt. of General Practice, University of Göttingen, Humboldtallee 38, 37073 Göttingen, Germany
2 Dpt. of General Practice, Preventive and Rehabilitation Medicine, University of Marburg, Robert-Koch-Str. 5, 35033 Marburg, Germany
3 Institute for Medical Psychology, University of Marburg, Bunsenstr. 3, 35037 Marburg, Germany
4 Dpt. of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Rd., Honolulu, HI 96822, USA
5 Dpt. of Anaesthesiology, Pain Clinic, University of Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
BMC Complementary and Alternative Medicine 2007, 7:42 doi:10.1186/1472-6882-7-42Published: 18 December 2007
Although back pain is considered one of the most frequent reasons why patients seek complementary and alternative medical (CAM) therapies little is known on the extent patients are actually using CAM for back pain.
This is a post hoc analysis of a longitudinal prospective cohort study embedded in a RCT. General practitioners (GPs) recruited consecutively adult patients presenting with LBP. Data on physical function, on subjective mood, and on utilization of health services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months
A total of 691 (51%) respectively 928 (69%) out of 1,342 patients received one form of CAM depending on the definition. Local heat, massage, and spinal manipulation were the forms of CAM most commonly offered. Using CAM was associated with specialist care, chronic LBP and treatment in a rehabilitation facility. Receiving spinal manipulation, acupuncture or TENS was associated with consulting a GP providing these services. Apart from chronicity disease related factors like functional capacity or pain only showed weak or no association with receiving CAM.
The frequent use of CAM for LBP demonstrates that CAM is popular in patients and doctors alike. The observed association with a treatment in a rehabilitation facility or with specialist consultations rather reflects professional preferences of the physicians than a clear medical indication. The observed dependence on providers and provider related services, as well as a significant proportion receiving CAM that did not meet the so far established selection criteria suggests some arbitrary use of CAM.