(Research Hub Theater) Effectiveness of Complementary and Adjunctive Medicine Compared to Opioids for Chronic Pain

Background and/or Objectives: To evaluate the use of complementary and adjunctive medicine (CAM) in chronic pain and their relative effectiveness compared to chronic opioids.

Design: Cross-sectional study using data from the 2019 National Health Interview Survey (NHIS).

Setting: Annual U.S. based healthcare survey.

Participants: Non-institutionalized adults (over the age of 18) who reported pain in the last three months prior to receiving the survey (n=19,262), stratified into those experiencing pain some days (n=12,078), most days (n=2,609) and every day (n=4,575).

Interventions: not applicable.

Main Outcome Measures: Prevalence of physical therapy (PT)/occupational therapy (OT) use, chiropractor use, talk therapy, yoga/tai chi, massage, meditation, other modalities, and effectiveness of these modalities on pain management. A secondary outcome was to determine if there are differences in the effectiveness of these modalities compared to chronic opioid use.

Results: Patients who reported some pain used massage for pain relief most often (14.9%), followed by meditation (13.1%) and yoga/tai-chi (10%). Similarly those with pain most days used massage (19.3%), followed by PT/OT (18.1%) and meditation (16.4%). Finally those with pain every day used PT/OT (21.7%), massage (16.2%) and meditation (16.2%). Chronic opioid use was highest among those with pain every day (74.8%), followed by most (55.5%) and some days (32.5%). Effectiveness of pain management strategies used was higher in the non-opioid group for those experiencing pain some days (62.3% vs 44.5%, p< 0.001) and all days (27.2% vs. 19.8%, p=0.036).

Conclusions: Recommending CAM for chronic pain could lead to greater benefit regardless of initially reported pain level.