VA Healthcare Connecticut Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, West Haven, Connecticut; Yale University School of Medicine Center for Medical Informatics, New Haven, Connecticut.
VA Healthcare Connecticut Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, West Haven, Connecticut; Yale University School of Medicine Center for Medical Informatics, New Haven, Connecticut.
J Manipulative Physiol Ther. 2021 May;44(4):330-343. doi: 10.1016/j.jmpt.2021.01.002. Epub 2021 Apr 23.
In this cross-sectional study, we examined correlates of manual therapy (spinal manipulation, massage therapy) and/or acupuncture use in a population engaging in conventional pain care in West Virginia.
Participants were patients (aged 18+ years) from 4 Appalachian pain and rheumatology clinics. Of those eligible (N = 343), 88% completed an anonymous survey including questions regarding health history, pain distress (Short Form Global Pain Scale), prescription medications, and current use of complementary health approaches for pain management. We used age-adjusted logistic regression to assess the relation of sociodemographic, lifestyle, and health-related factors to use of manual therapies and/or acupuncture for pain (complete-case N = 253).
The majority of participants were white (92%), female (56%), and middle aged (mean age, 54.8 ± 13.4 years). Nearly all reported current chronic pain (94%), and 56% reported ≥5 comorbidities (mean, 5.6 ± 3.1). Manual therapy and/or acupuncture was used by 26% of participants for pain management (n = 66). Current or prior opioid use was reported by 37% of those using manual therapies. Manual therapy and/or acupuncture use was significantly elevated in those using other complementary health approaches (adjusted odds ratio, 3.0; 95% confidence interval, 1.5-5.8). Overall Short Form Global Pain Scale scores were not significantly associated with use of manual therapies and/or acupuncture after adjustment (adjusted odds ratio per 1-point increase, 1.01; 95% confidence interval, 1.00-1.03).
We found no evidence for an association of pain-related distress and use of manual therapies and/or acupuncture, but identified a strong association with use of dietary supplements and mind-body therapies. Larger studies are needed to further examine these connections in the context of clinical outcomes and cost-effectiveness in rural adults given their high pain burden and unique challenges in access to care.
在这项横断面研究中，我们研究了西弗吉尼亚州接受常规疼痛治疗的人群中，接受手法治疗（脊柱推拿、按摩疗法）和/或针灸治疗的相关因素。
参与者为来自阿巴拉契亚地区 4 家疼痛和风湿病诊所的患者（年龄≥18 岁）。在符合条件的患者（n=343）中，88%完成了一项匿名调查，内容包括健康史、疼痛困扰（简短全球疼痛量表）、处方药物以及当前用于疼痛管理的补充健康方法。我们使用年龄调整后的逻辑回归来评估社会人口统计学、生活方式和健康相关因素与手法治疗和/或针灸治疗疼痛的关系（完全病例数 n=253）。
大多数参与者为白人（92%）、女性（56%）和中年（平均年龄 54.8±13.4 岁）。几乎所有人都报告有当前的慢性疼痛（94%），56%的人报告有≥5 种合并症（平均 5.6±3.1）。有 26%的参与者（n=66）使用手法治疗和/或针灸治疗疼痛。有 37%的使用手法治疗的人报告目前或以前使用过阿片类药物。与未使用补充健康方法的人相比，使用其他补充健康方法的人使用手法治疗和/或针灸的可能性显著更高（调整后的优势比，3.0；95%置信区间，1.5-5.8）。总体简短全球疼痛量表评分在调整后与使用手法治疗和/或针灸之间没有显著关联（每增加 1 分的调整后的优势比，1.01；95%置信区间，1.00-1.03）。
我们没有发现疼痛相关痛苦与使用手法治疗和/或针灸之间存在关联的证据，但发现与使用膳食补充剂和身心疗法之间存在很强的关联。鉴于农村成年人的疼痛负担高，且在获得医疗保健方面存在独特挑战，需要更大规模的研究来进一步研究这些关联在临床结局和成本效益方面的情况。
