P-112 - Evaluating Patients' Perceptions of Integrative Therapies and Self-Healing for Musculoskeletal Pain: A Worldwide Survey

Abstract Title: Evaluating Patients' Perceptions of Integrative Therapies and Self-Healing for Musculoskeletal Pain: A Worldwide Survey


Background: Musculoskeletal (MSK) pain is managed through conservative methods, non-pharmacological and pharmacological treatments.¹ Due to the potential side effects and lack of consistent benefit from some commonly used pharmacological therapies, multimodal integrative treatment approaches that combine conventional and alternative/complementary approaches are gaining acceptance and inclusion in global treatment guidelines for MSK pain. These drug-free pain relief methods are based on the premise of optimizing the body's innate ability to heal itself.^2,3 Despite the availability of evidence-based support, many healthcare professionals and patients remain unaware of the self-healing concept, limiting the integration of these approaches into MSK pain management. Understanding the lack of awareness about the self-healing concept and identifying the reasons for these gaps is crucial. This information should help guide future efforts to include self-healing in the treatment and care of MSK pain.

Purpose/Objectives: This study aimed to assess the gaps in understanding and credibility of the self-healing concept among patients and to identify the contributing factors.

Methods: An international, cross-sectional survey was administered online to patients (N=1805) who had experienced MSK pain in past 12 months across the U.S., Australia, Brazil, France, Germany, and China. The questions included patients’ sociodemographic characteristics, treatments utilized, attitudes, beliefs, and perceptions regarding specific treatment modalities, and changes in attitudes, beliefs, and perceptions regarding self-healing before and after exposure to a self-healing concept. Patients were grouped into four clusters based on age, gender, health literacy, pain course, severity, interference and their belief that their condition will resolve: cluster 1 (55-65 years [y], highest level of pain), cluster 2 (18-34 y female, moderate level of pain), cluster 3 (45-65 y male, mild level of pain) and cluster 4 (18-24 y, lowest level of pain). Seven factors (F) were identified based on patients’ beliefs and perceptions: F1: belief in drug-free + holistic approaches; F2: pain as a multifactorial condition; F3: drawbacks of drug-free therapies; F4: self-efficacy in using drug-free therapies; F5: limitations of pain medications; F6: doubt in self-healing/endorse devices; F7: minimal side effects of drug-free therapy. Repeated-measures analysis compared key variables pre- and post-concept exposure, cluster analysis segmented patients together based on pain, and linear regression identified factors that account for these gaps.


Results: Pre-concept exposure, patients were cognizant of the side effects of pain medications and wanted to reduce reliance on them (extremely/quite confident 48%). Alternative/complementary treatments such as acupuncture and far infra-red therapies inspired less confidence and agreement about their effectiveness (slightly/not at all confident 46%). However, post-concept exposure, there was a slight increase in confidence and agreement across all statements and all countries. These statements included treating pain with drug free approach (extremely/quite confident increased from 32% to 44%), minimal side effects (extremely/quite confident increased from 36% to 46%), the body’s ability to heal itself (extremely/quite confident increased from 34% to 50%), physiotherapy’s role in reducing pain (extremely/quite confident increased from 47% to 55%), infra-red aids healing (extremely/quite confident increased from 28% to 38%), and long-term pain relief provided by acupuncture (extremely/quite confident increased from 36% to 46%). Time, cost, and effort required for these treatments to be effective were identified as major barriers to adopting them. Cluster 2 held a positive view towards F1 for facilitating healing and pain relief. These patients, despite facing moderately challenging pain, maintained a sense of hope for healing. Additionally, they embraced drug-free therapies, however they also acknowledged potential of F3. This belief is especially prevalent with younger women suffering from joint pain/osteoarthritis in China, who also believed in F4. Their nuanced perspective highlights openness to various pain management approaches. In Brazil, cluster 2 recognize pain complexity (F2) and support F6. In contrast, cluster 1 in China emphasizes pain as multifactorial (F2) and favor F1 for pain relief. Both cluster 1 and cluster 3, share a common belief on F5, may not always fully relieve pain. In Australia, cluster 3 also embraces F7, suggesting they are open to self-healing modalities. However, cluster 1 doubts about the body's self-healing abilities and questions effectiveness of F1, preferring device-based approaches (F6). Finally, cluster 4 strongly agree with F7, reflecting optimism about managing pain.

Conclusions/Implications for future research and/or clinical care: Patients showed a preference for holistic and integrative approaches to treating pain prior to exposure to the self-healing infographic. Post-concept to the infographic, patients demonstrated greater openness to holistic and integrative pain management strategies. Patients’ lack of confidence in lesser-known self-healing methods suggests the need for further development of evidence-based educational content on self-healing modalities.


References:

1. Babatunde OO, et al. PLoS One. 2017;12(6):e0178621.


2. McSwan J, et al. J Pain Res. 2021;14:2943-2958.


3. Mobasheri A. J Pain Res. 2022;15:3479-3482.