WEST HAVEN, CT — Effectiveness of nonpharmacological pain treatment modalities (NPMs) is supported by strong evidence, but not enough is known about the prevalence or correlates of NPM use, according to a new study.

The report in the Journal of General Internal Medicine reviewed rates and correlates of NPM use in a sample of veterans who served during recent conflicts.1

VA Connecticut Healthcare System-led researchers examined rates and demographic and clinical correlates of self-reported NPM use, such as psychological/behavioral therapies, exercise/movement therapies and manual therapies.

Participating were 460 veterans with pain lasting three months or more who completed the baseline survey. The veterans were an average of 33.76 years old, 56.3% female and 80.2% white. The main outcome was defined as self-reported use of NPMs in the past 12 months.

Results indicated that, in terms of NPM use, 22.6% reported using psychological/behavioral, 50.9% used exercise/movement and 51.7% used manual therapies. More likely to use psychological/behavioral therapies were veterans with a college degree (vs. no degree; OR = 2.51, 95% CI = 1.46, 4.30, p = 0.001) or those with worse mental health symptoms (OR = 2.88, 95% CI = 2.11, 3.93, p < 0.001).

Veterans who were female (OR = 0.63, 95% CI = 0.43, 0.93, p = 0.02) or who used nonopioid pain medications (OR = 1.82, 95% CI = 1.146, 2.84, p = 0.009) were more likely to use exercise/movement therapies, the researchers reported.

Manual therapies were more likely to be used by veterans who were nonwhite (OR = 0.57, 95% CI = 0.5, 0.94, p = 0.03), with greater educational attainment (OR = 2.11, 95% CI = 1.42, 3.15, p < 0.001), or who used nonopioid pain medication (OR = 1.71, 95% CI = 1.09, 2.68, p = 0.02).

“Results identified demographic and clinical characteristics among different NPMs, which may indicate differences in veteran treatment preferences or provider referral patterns,” study authors noted. “Further study of provider referral patterns and veteran treatment preferences is needed to inform interventions to increase NPM utilization. Research is also need to identify demographic and clinical correlates of clinical outcomes related to NPM use.”

1Edmond SN, Becker WC, Driscoll MA, Decker SE, Higgins DM, Mattocks KM, Kerns RD, Haskell SG. Use of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain: Results from a Cross-Sectional Survey. J Gen Intern Med. 2018 May;33(Suppl 1):54-60. doi: 10.1007/s11606-018-4322-0. PubMed PMID:29633141; PubMed Central PMCID: PMC5902341.