Chronic Pain Patients Using Alternative Care – Not Telling Their Doctors

Chronic Pain Patients Using Alternative Care - Not Telling Their Doctors

A majority of chronic pain patients who are enrolled in a managed health care plan are using chiropractic care or acupuncture or both.

But many aren’t telling their primary care providers about it.

That’s the gist of a study that was released in the American Journal of Managed Care this week.

Researchers surveyed more than 6,000 patients in Oregon and Washington who were Kaiser Permanente members between 2009 and 2011. 58% of those patients surveyed reported they had used chiropractic care or acupuncture or both.

35% of them who had acupuncture and 42% who saw a chiropractor didn’t talk to their providers about the care.

“Our study confirms that most of our patients with chronic pain are seeking complementary treatments to supplement the care we provide in the primary care setting,” said Charles Elder, MD, MPH, lead author of the study and affiliate investigator at the Kaiser Permanente Center for Health Research. “The problem is that too often, doctors don’t ask about this treatment, and patients don’t volunteer the information.”

Chronic pain affects approximately 100 million Americans each year and costs nearly $600 billion, according to a report from the Institute of Medicine.

To find out how patients accessed this care researchers examined the medical records of patients who received acupuncture or chiropractic care in 2011. The majority of patients (66 percent) who received acupuncture accessed the services through their health plan, using a clinician referral or self-referral benefit. About half (45 percent) of patients who received chiropractic care accessed that care through their health plan. The remainder of patients went outside the health plan to access these services, or used a combination of health plan and outside resources to access the services.

The majority of the patients in the study (71 percent) were women, and the mean age was 61. Common complaints included back pain, joint pain, arthritis, extremity, neck and muscle pain, and headache.

Dr. Elder, who is also the physician lead for Kaiser Permanente’s complementary and alternative medicine program, added, “We want our patients to get better, so we need to ask them about the alternative and complementary approaches they are using. If we know what’s working and what’s not working, we can do a better job advising patients, and we may be able to recommend an approach they haven’t tried.”



Authored by: Ed Coghlan

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Dennis Kinch

To Marty - I’m so happy you found a doctor who really cares, but like you said, “I only wish there were more like him.” But there aren’t. So I think I would say, “Approach your doctor with information carefully, a little at a time. Drop small hints to see if he is”old school” or open minded.” As much as I hate to say this, he holds your whole being in his hands. I’ve seen it personally, 3 times over, and I have heard from many patients, horror stories worse than mine. So please, go easily.

And Janet - You never said what worked! Not medical, complimentary or alternative? What’s left? I’m dying to know.


I tell my doctor everything. Unlike what I have heard about some doctors my doctor only cares about what is going to help me. I have been blessed. In fact a few weeks ago I had a surprise visit from one of my sons and I didn’t want to miss out on doing things with him because of my back pain and using a walker. We went to the Farmer’s Market which I hadn’t been to in years and there was a woman there doing massages. I expressed my doubt since I have tried everything under the sun. She said if I wasn’t happy she wouldn’t charge me so I tried it. 10 minutes of her working her skillful hands was unbelievable. So I was telling my doctor about this and how in 3 years I had a day of dull pain. He knows I don’t have much money but because he cares my doctor has offered to pay 3 months of massage therapy with her. Not sure what I will do after that but just the fact that this man believes in his profession and understands pain is a wonderful feeling. I only wish there were more like him. So tell your doctor everything. He may surprise you with his compassion.

When I was suffering with chronic debilitating fibromyalgia I tried anything and everything I could find, both complementary and alternative as well as medical treatments. My general practitioner was very open and administered acupuncture himself. He referred to me as, “a doctor’s worst nightmare,” for nothing he tried or recommended was working. I am grateful to him for his open mindedness towards complementary and alternatives which kept me searching until I finally found what for me. I have been both pain and prescription free for almost 15 years.

Dennis Kinch

When I had had some chiropractic care, I told my doctor, an Osteopath, and he said that if I continued he would have to tell my insurance and they would see it as “Not following the treatment plan laid out by an approved doctor.” Thus they would cancel my case. I never said anything to a doctor about alternative care including herbal supplements and acupuncture for fear of losing my insurance. I recently had hypnosis which helped a lot and never mentioned it to my PC.

There are other reasons I couldn’t tell a doctor much, mainly because I couldn’t see him as being on my side. This is due to it taking 10 years to get a diagnosis and them thinking I was doing something to thwart the treatment. This is one of the major things that needs fixing in chronic pain treatment. The idea that a patient has a lot of time, a lot of interest and usually a computer should make them the best candidate to do research and be a part of the team, but a doctor doesn’t even see his nurses as a viable diagnostic team member. There is a huge trust issue among everyone involved.

On the other side of this are the clinics who invite alternative care (to a point) into the fold, and a few actually had practitioners “on site.” This was extremely rare to see, and I saw hundreds of clinics. If 58% of pain patients use alternative care and this is usually out of pocket, this should tell us something. Not only the level of interest by the patients, but also the level of “trying things to stop the pain!” I’d love to see the success rates. Imagine if these practices were covered by insurance! Just more Weapons of Healing!


My primary doctor and my Rheumatologist refuse to converse with me on alternative methods for chronic pain and fatigue save for physical therapy and exercise this treatment is a setback for me taking weeks to recover.

Primary dr has informed me fibromyalgia/ CFS is a psychological illness and anti depressants should be used. I take antidepressants - I continue to have symptoms and doc’s advice is to exercise. I no longer discuss fibromyalgia with him and am now seeking another primary doctor.

My Rheumatologist’s view is the same. I asked for a prescription for LDN (low dose naltrexone) but he refuses says it’s an opiate and will not prescribe or converse with me about it. I am now seeking another rheumatologist.

My pain doctored, at my request, stopped my pain killers and prescribed LDN, which by the way has lessened my symptoms of both fibromyalgia and RA. I believe there are more doctors than not that want to dish out orders, not listen to the patient (who quiet frankly know more about chronic pain than the doctors do).

The doctor who does want to have a relationship with their patient will communicate with the patient, keep an open mind and embrace the opportunity to learn!