Adding Self-Care Complementary and Integrative Health Therapies to Care for Chronic Pain: The Assessing Pain, Patient Reported Outcomes and Complementary Health (APPROACH) Study.

Researchers studied whether adding self-care therapies like yoga, meditation, and Tai Chi to practitioner-delivered treatments would help veterans with chronic musculoskeletal pain more than practitioner treatments alone. The study followed 3,306 veterans across 18 medical centers who received either acupuncture, chiropractic care, or massage therapy, with some also participating in self-care practices. Both groups showed similar improvements in pain-related functional interference after six months, with about 40% of participants achieving meaningful pain reduction. However, patients who combined practitioner treatments with self-care therapies were more likely to report that their complementary health approach specifically improved their pain (by 11%), fatigue (by 28%), mental health (by 24%), and overall well-being (by 27%) compared to those who only received practitioner-delivered care. This suggests that while both approaches help reduce pain's impact on daily life, adding self-care practices provides additional benefits across multiple aspects of health. The findings support the growing trend of health systems expanding coverage for these therapies and suggest that patients dealing with chronic musculoskeletal pain may benefit from incorporating self-care complementary therapies alongside treatments like acupuncture. If you're considering acupuncture as part of your pain management plan, seek a licensed acupuncturist certified by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

This pragmatic nonrandomized trial (n=3,306) examined whether combining practitioner-delivered complementary and integrative health (PD-CIH) therapies (acupuncture, chiropractic, massage) with self-care modalities (yoga, mindfulness/meditation, Tai Chi/Qigong) improved outcomes versus PD-CIH alone among veterans with chronic musculoskeletal pain across 18 VA medical centers. Primary outcome was change in pain-related functional interference at 6 months. Both arms demonstrated clinically significant improvements in pain interference (-0.62 and -0.70), with approximately 40% achieving meaningful improvement and no significant between-group difference (-0.12; 95% CI: -0.28 to 0.05). However, the PD/SC-CIH arm reported significantly greater perceived improvements attributed to CIH therapies across pain (11%), fatigue (28%), mental health (24%), and overall well-being (27%). Clinical implications support recommending self-care CIH modalities as adjuncts to practitioner-delivered therapies for chronic musculoskeletal pain, potentially enhancing patient-perceived multidimensional health benefits without additional pain interference reduction.