Complementary and Alternative Therapies for Managing Arthritis Pain
By Gail C. Davis, RN, EdD
Objective: To compare the use of complementary and alternative medicine (CAM) for arthritis between two ethnically distinct metropolitan Chicago community areas.
Methods: A telephone interview survey of adults age 45 years or older living in North (88.9% white) or South (79.7% African American) areas. Of 763 respondents, 405 reported arthritis or chronic joint symptoms and were asked about use and satisfaction with seven CAM therapies. Differences between areas were compared with population-weighted tests; multiple logistic regression was used to analyze the likelihood of CAM use controlled for demographics, behavioral risk factors, and arthritis severity.
Results: South Chicago respondents had a higher prevalence and more severe arthritis symptoms such as mean joint pain and more functional limitations. Use of CAM therapy by South Chicago respondents, most commonly massage and relaxation techniques, was 10% greater than North Chicago respondents (61.5% to 51%), but this was not significantly different. Among CAM users, South Chicago respondents reported higher satisfaction with six of the seven CAM therapies and greater future interest in CAM therapies. Poor overall health status (p=0.03), arthritis pain (p=0.005), and concomitant use of prescription medications (p=0.03) were the only significant predictors of CAM use.
Discussion: Although there were only small differences in overall CAM use by area, older residents of largely African American communities were enthusiastic users of relaxation, massage, and nutritional and dietary techniques. CAM modalities could be important adjuncts to traditional medical treatment of arthritis pain for minority communities.
The authors note that treatment approaches for the pain and disability associated with arthritis can be very expensive. CAM therapies are often adopted by individuals as approaches to dealing with pain and joint symptoms. Personal characteristics associated with those most likely to turn to CAM use are not well understood. This study specifically addressed the variables of demographics (e.g., income level, educational level, and ethnicity), health-related risk factors (e.g., obesity or uninsured), and arthritis severity (e.g., perceived health status, prescription medicines, and pain severity) as possible predictors of CAM use.
Study data were based on telephone interviews using selected arthritis questions from the Centers for Disease Control (CDC) Behavioral Risk Factor Surveillance System (BRFSS) (www.cdc.gov/brfss). The sample (n=763) was selected to represent two culturally diverse Chicago-area communities referred to as South Chicago (n=414) and North Chicago (n=349). The variables of ethnicity, income, education, insurance, body mass index (BMI), and arthritis or chronic joint symptoms (CJS) were significantly different between the two groups. The South Chicago group was primarily African American (79.9%); had lower income, educational level, and insurance coverage rates; were less frequently married; and had greater BMIs and frequency of arthritis or CJS. The mean age of both groups was 60.