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Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain

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Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain

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SOURCE:   J Am Board of Family Medicine 2010 (May); 23 (3): 354-362

Kanodia AK, Legedza AT, Davis RB, Eisenberg DM, Phillips RS.

Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School Osher Research Center, Boston

A new article, published in the Journal of the American Board of Family Medicine [1] reports on interviews with 31,044 individuals who used CAM for low back pain. The results are quite fascinating:

  • The top 6 CAM therapies for LBP, starting with the most-used approaches are: chiropractic, massage, herbal therapy, acupuncture, yoga/tai chi/qi gong, and relaxation techniques.
  • Chiropractic use (76% of respondents) was larger than all the other 5 therapies combined (see Figure 1)
  • Chiropractic users scored their satisfaction (and clinical benefits) the highest of all 6 approaches (see Table 2).

    This reconfirms earlier findings from the Archives of Physical Medicine & Rehabilitation 2005, which reported that:

    SMT provided the greatest pain relief [7.33], scoring higher than:

    nerve blocks (6.75),
    Opioid analgesics (6.37),
    muscle relaxants (5.78),
    Acupuncture (5.29), or
    NSAIDs (5.22)
    . [2]

  • Of those who used CAM modalities for back pain, 69% of these respondents only used one CAM therapy
  • Of those who used CAM modalities for back pain, 27% used it because conventional medicine did not help, 53% used it in conjunction with medical care, and only 24% used it because their medical provider recommended it (see Table 3)
  • The researchers used Multivariable Analysis to determine the factors independently associated with the perception of a “great deal” of benefit in this group. Interestingly, the factor associated with the greatest benefit from care was in the group that said that “conventional medicine would not help”. The least benefits were experienced by those referred by a conventional pratitioner.

Figure 1: Use of the 6 most frequently used complementary and alternative medicine (CAM) modalities for back pain during the previous 12 months. These modalities are not mutually exclusive and are limited to respondents for whom back pain was one of the 3 most bothersome medical conditions..

Table 2. Perceived Benefit of the 6 Most Frequently Used Complementary and Alternative Medicine Modalities for Back Pain

Those with Great Benefit from CAM
(Weighted %)
Chiropractic (n = 1,163)
Massage (n = 196)
Yoga, Tai chi, Qi Gong (n = 45)
Acupuncture (n = 89)
Herbal therapies (n = 78)
Relaxation techniques (n = 76)

Table 3. Reasons for Using the 6 Most Frequently Used Complementary and Alternative Medicine Modalities for Back Pain

Reasons for Use
CAM Users Who Reported Reasons for Use (%) (n = 1,647)
Used conventional medicine and CAM together
Interested in trying CAM
Conventional medical treatment would not help
Conventional medical practitioner suggested CAM
Conventional medical treatment was too expensive

There are many more articles like this @:

Patient Satisfaction With Chiropractic


  1. Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain: A National Survey
    Journal of the American Board of Family Medicine 2010 (May); 23 (3): 354-362 ~ FULL TEXT

  2. Chronic Pain in Persons With Neuromuscular Disease
    Archives of Physical Medicine & Rehabilitation 2005 (Jun); 86 (6): 1155–1163 ~ FULL TEXT

About the Author:

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.


  1. DrBenjamin June 1, 2010 at 6:43 pm

    We need more research articles like this in the community–as chiropractors this is nothing new to us, but the public may be surprised that we offer better results to our patients compared with conventional medicine.

  2. Chiropractor Singapore June 2, 2010 at 1:05 am

    This is wonderful news. I hope that many family doctors (MD’s) will read that article and understand how many patients see value in chiropractic.

    Will Kalla DC
    Blog: The Singapore Chiro

  3. EvidenceBasedDC June 3, 2010 at 7:22 am

    Maybe we are approaching the point where we’re considered neither “complementary” nor “alternative”?

  4. EB, DC

    I guess it’s a matter of perspective. I like the term “alternative” because it’s factual. We are an alternative to standard medical approaches.

    They like the term “complementary” because it makes us sound like an appendage to medicine. Which would you prefer? It’s all semantics, but I prefer it work in our favor.

  5. nene June 3, 2010 at 8:40 pm

    I strongly disagree.

    From my “perspective”:

    “alternative” insinuates an inflammatory and destructive, ‘Us vs Them’, ‘Either/Or’, mentality. Is that REALLY what we want? Is that adversarial perception REALLY how we want to be regarded?

    No one can dispute the cultural authority of allopathy. It is what it is. HOWEVER- We are steadily gaining ground into the portals available to provide chiropractic care(ie. the VA, and the most recent federal passing to expand VA chiropractic care)……This is HUGE!!

    Chiropractic is being steadily integrated into the options available for the mainstream population. We are working side by side with other professionals, each COMPLEMENTING the other……as a team…. for the best of the patient… it should be.

    Please leave egos(and semantics) at the door.

    RESPONSE from Frank:

    Nicely stated. Yes, there are a few (30?) DCs working in the VA now, and by 2012 there will be almost 140. That’s still a tiny fraction of 1% of the profession.

  6. nene June 4, 2010 at 1:38 pm

    My post was not meant to imply that DCs in the VA are the only DCs in integrative practices.

    We have DCs in hospitals, DC departments in hospitals, DC chairs at universities, DCs in prestigious clinics(ie, Texas back Institute), DCs teaching at medical schools(ie. Donald Murphy at
    Brown Medical school, Terry Yochum in Colorado,…to name just a few),…….DC presence is becoming “mainstream”…….part of the “best-practices” available to patients.

    YUP!! DCs are integrating into available patient options….patients no longer need to keep their visits to the DC a secret…..MDs are actually referring to DCs…………..YUP!

    I do not consider that to be “alternative”…..rather a victory for patients….who can now compliment and integrate chiropractic care and chiropractors, freely, as part of their healthcare team.

  7. Frank June 4, 2010 at 2:43 pm


    I still don’t get your point.

    Yes, things are improving. But, what has that got to do with us being an alternative from standard medical practice? I completely disagree with your suggestion that alternative means an “inflammatory and destructive, ‘Us vs Them’, mentality”

    DCs have only been “welcomed in” because we actually offer a unique, different (alternative) approach. Working on a team is not synomonous with losing (or supressing) those differences. What it means is that these other professions are feeling less threatened by that difference!

  8. Sandy Utah Chiropractor June 9, 2010 at 11:58 pm

    It’s a good thing that more and more people are now considering chiropractic as their alternative medicine.

  9. Boulder chiropractors November 9, 2010 at 5:41 pm

    Overall this is great news and is only a fraction of the ‘alternative’ tidal wave that is sweeping through the country as people realize that they have only been socialized into trusting allopathic ways and brainwashed by all of billions spent by BigPharma on advertising directly to the ‘consumer’. Go Chiro!

  10. Henard March 22, 2012 at 9:41 am

    I’m really amazed by this blog. Tons of useful posts and info on here.

    Thumbs up, thanks a lot.

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