Previous studies have shown that more than 50% of patients choose to use complementary and alternative medicines alongside conventional medicine to manage musculoskeletal conditions. Research led by Keele University analysed patients’ reasoning for using these alternative methods, identifying four key themes; practicality, effectiveness, additional outcomes, and philosophy of illness and care.

Musculoskeletal conditions (e.g. injury, damage or disorders causing pain in the joints, muscles, tendons, ligaments and nerves) are estimated to be the most common reason for disability across the globe.

At present, complementary and alternative medicine approaches, such as acupuncture, are not consistently recommended as treatments for musculoskeletal pain in national health care guidelines, whilst others, such as aromatherapy, are not included at all. Despite the lack of evidence or endorsement of these alternative treatments, patients continue to use them.

The study, which was a systematic review funded by Arthritis Research UK, analysed 152 published studies, identifying 1486 different justifications provided by patients for or against their use of complementary and alternative medicines. These could be grouped into four broad themes;

Practicality

Ease of access (e.g. cost, time, and availability), formal and informal referral (from GPs, healthcare professionals, family and friends, media, celebrities, and patients with similar conditions), and feelings of despair and hopelessness, were all motivating factors for seeking complementary and alternative treatments.

Effectiveness

If patients considered an alternative treatment to be a more effective approach, felt it achieved a specific goal (e.g. increased their energy), or had confidence or ‘faith’ that it would work, they would also consider its use. This demonstrates that, despite specific scientific backing for orthodox medicine approaches, patients will continue to experiment for themselves to understand what works for them as an individual.

Additional outcomes

Dissatisfaction with both conventional care and healthcare professionals themselves also led to patients seeking alternative treatments. Safety issues were also taken into consideration, with many patients expressing the belief that alternative therapies are safer with fewer side effects.

Philosophy of illness and care

The severity of pain, religious and personal beliefs (e.g. alternative therapies are more ‘holistic’ and ‘natural’ than orthodox treatments), and the relationship between the patient and the complementary or healthcare practitioner were all reported as key justifications. Patients also reported that the choice to use alternative treatments gave them a degree of freedom, and felt that they were able to take control and be proactive about their own healthcare.
For some patients in the studies analysed, the same four themes also summarised reasons why they chose or preferred orthodox over complementary or alternative treatments for their musculoskeletal problems.

Research Associate, Dr Nadia Corp explained:

“Although lumping together medicine as either ‘orthodox’ or ‘complementary and alternative’ is rather artificial, the common view is that there are complementary and alternative therapies that can be considered as a group and that are not part of conventional medicine.
“This study highlights that some patients with musculoskeletal problems see such complementary and alternative medicine as a good way to meet their needs for time, support for self-management, and holistic care, and therefore has a significant role for patients with common painful long-term conditions in providing choice and enabling individual needs to be met.”

Keele University Emeritus Professor of Primary Care Epidemiology, Peter Croft, added;

“This study is a key starting point in identifying whether patients feel that orthodox care is or is not meeting their expectations, and opens up the debate about whether the use of complementary and alternative medicines can be integrated into a model of care for patients with chronic pain and disability from musculoskeletal conditions.”

The research was published today, in PLOS ONE.