Complementary and Integrative Health Approaches for Low Back Pain in Veterans: A Narrative Review.

Researchers reviewed evidence on complementary and integrative health (CIH) approaches for chronic low back pain in military veterans. Chronic low back pain is the most common pain condition affecting veterans, leading to disability, reduced quality of life, and dependence on opioid medications. The study examined various non-drug treatments including acupuncture, yoga, Tai Chi, Qigong, mindfulness, chiropractic care, massage, and cognitive-behavioral therapy.

The review found that while research specifically on veterans is limited, these approaches show promise. Battlefield acupuncture—a specific ear acupuncture technique—demonstrated meaningful reductions in pain intensity. Yoga, Tai Chi, Qigong, and mindfulness offered modest improvements in both pain and physical function. Chiropractic care and massage showed mixed results with moderate effectiveness. The strongest outcomes came from combining multiple complementary therapies with conventional medical care, which not only reduced pain but also lowered opioid prescriptions and improved patients' ability to cope with their condition.

For veterans with chronic low back pain, these findings suggest that acupuncture and other complementary approaches can be valuable additions to standard care. Battlefield acupuncture in particular may offer quick pain relief. Combining acupuncture with movement therapies like yoga or Tai Chi and mind-body practices may provide the best results. These treatments also offer the benefit of reducing reliance on pain medications. However, access to these services varies across VA facilities, and provider availability remains a challenge. If you're a veteran considering acupuncture for low back pain, seek a licensed acupuncturist experienced in treating chronic pain conditions, preferably one familiar with veteran-specific needs.

This narrative review synthesized peer-reviewed literature from 2010-2025 examining complementary and integrative health (CIH) approaches for chronic low back pain (cLBP) in veterans, using a biopsychosocial framework. The analysis included systematic reviews, RCTs, observational studies, and evidence maps, prioritizing veteran-specific research. Findings indicate battlefield acupuncture produced clinically meaningful pain reductions, while yoga, Tai Chi, Qigong, and mindfulness demonstrated modest improvements in pain and function. Cognitive-behavioral therapy, chiropractic care, and massage showed mixed results with low-to-moderate certainty and limited durability. Multimodal interventions integrating CIH with conventional care yielded the strongest outcomes, including reduced opioid prescriptions, improved coping mechanisms, and potential cost savings. Specific effect sizes were not reported. Implementation barriers include provider shortages, administrative challenges, and inequitable facility access. Clinical takeaway: Multimodal CIH approaches, particularly incorporating battlefield acupuncture, represent evidence-based adjuncts for veteran cLBP management with opioid-sparing potential, though veteran-specific RCTs are needed to strengthen the evidence base.