Use of complementary and alternative medicine in chronic pain A survey among patients in a pain clinic

Background Chronic pain patients represent the population with the highest use of complementary and alternative medicine (CAM). Current data on the usage, prescription and reasons for using CAM in Germany remain unclear and have not yet been published. Objectives The aim of this study was to evaluate details regarding interest and use as well as reasons for using CAM in chronic pain patients. Methods In all, 60 of 64 consecutive patients referred to the multimodal pain therapy program in a specialized day hospital participated in the study. In addition to the German Pain Questionnaire, patients answered a self-developed questionnaire on CAM use. CAM was defined according to the guidelines of the NCCIH (National Center for Complementary and Integrative Health). Results The study showed that 96.7% of patients were interested in CAM and all 60 participants had used CAM to influence pain (3-26 different CAM modalities, median: 12). The most frequently used were massage (95%), acupuncture (73%), nutriceuticals and vitamin preparations (72% each). The success of the therapies was predominantly evaluated as short-lasting. CAM was often prescribed by a specialist (61.7%) or family doctor (60%). For most patients, the greatest motivation for using CAM was the desire to become active themselves (76.7%). Greater impairment due to pain was associated with increased use of biological CAM methods, while higher pain intensity was associated with decreased use of biological and alternative CAM methods. Conclusions The high use of CAM in chronic pain patients highlights the need for physicians to have adequate medical knowledge about each CAM modality and to communicate competently with the patients about them.