Title : Expectations and experiences of use of complementary and alternative medicine for low back pain: A meta-ethnography
Abstract:
Background: Non-pharmacological pain therapy refers to interventions that do not involve the use of medications to treat pain. The goals of non-pharmacological interventions are to decrease fear, distress and anxiety, and to reduce pain and provide patients with a sense of control (El Geziry et al., 2018). Low back pain (LBP) is a global health problem that affects approximately 84% of adults at least once in their lifetime (Thiese et al., 2014; Ng et al., 2023). Chronic low back pain (CLBP), defined as LBP that lasts longer than 12 weeks (Thiese et al., 2014), has a lifetime prevalence of approximately 23% (Bushnell et al., 2018). Complementary and alternative medicine (CAM) refers to a broad range of healing modalities external to the biomedical models of healthcare with an array of nonprescription products and health-care services not linked to the medical profession or the medical curriculum (Adams et al., 2017; Murthy et al., 2015). Most commentaries have been on the rising popularity of CAM, although it is unclear how the recent global economic downturn has affected this, especially given that few CAMs are available either on national or private health insurance schemes (Gale, 2014). Again, treatment for CLBP is known to be a continuing challenge and that CLBP patients are likely to explore multiple treatments, to date, there has been no meta-ethnography on expectations and experiences on the use of CAM among CLBP pain patients. Therefore, this meta-ethnography has become necessary to synthesize the qualitative findings of the expectations and experiences of use of CAM for CLBP.
Method/Design: This review used meta-ethnography (Noblit & Hare, 1988) to synthesize qualitative research presented in published literature on the expectations and experiences of use of CAM for low back pain. The eMERGe Meta-Ethnography Reporting Guidance (France et al., 2019) was used.
Literature Search: Three databases were searched: CINAHL Plus with Full Text, PubMed, and APA PsycINFO for articles published from 2015-2025.
Results: Eighty-one articles were identified from the databases but 8 met inclusion criteria. Total sample was 141. Majority were from the USA. Five studies used thematic data analysis, 2 used content analysis and the other used coding. Two used grounded theory design, 4 were descriptive qualitative, and the others were explorative qualitative approach. Three overarching themes were identified, Motivation and Social Support, Perceived Benefits, and Barriers and Dissatisfaction and eight sub-themes.
Implications/Conclusion: Findings suggest that CAM interventions have the potential to improve CLBP management, particularly when they incorporate patient-centered communication, clear instruction, culturally responsive delivery, and sustained support. Future research should examine the mechanisms through which CAM fosters changes in pain perception, function, and well-being, while also addressing the structural barriers that limit engagement. Enhancing the design, accessibility, and integration of CAM within health systems may ultimately improve patient outcomes and broaden the range of effective, acceptable options for individuals experiencing low back pain.
