Research: ONO and COLLEAGUES,

Listed in Issue 161


ONO and COLLEAGUES, Department of Epidemiology and Health Care Research, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.  researched the relationship between use of  Complementary and Alternative Medicine and internal health locus of control (HLC) for low-back pain (LBP).


Given that persons with a stronger belief in internal health locus of control (HLC) have been shown to comply well with medical advice, HLC internality may play an important role in low-back pain (LBP) prevention and management because it requires the patient's own commitment. Previous studies in conditions other than LBP have shown that the use of complementary and alternative medicine (CAM) is associated with high HLC internality. Here, we examined the relationship between CAM facility visits and internality of HLC in persons with LBP.


We analyzed the data from the Health Diary Study, which surveyed the health-related behaviour of 3477 persons sampled from the general population of Japan. Among 2377 participants aged 18 to 75 years, 673 reported LBP during the study period. We examined CAM facility visits and HLC among 81 previously untreated LBP patients who sought care from western medical doctors or CAM providers during the 1-month study period.


Of the 81 patients, 40 reported at least 1 CAM visit, whereas 41 visited western medical doctors only. Participants who visited CAM facilities had a higher internality score than those who visited western medical doctors after controlling for age, sex, size of residential city, and bodily pain score of the Short Form-8 Health Survey scale.


Visitors to CAM facilities had a stronger belief in internal HLC. This finding suggests that visitors to CAM facilities are more sensitive to educational intervention for the self-management of LBP than those who visit western medicine. In order not to miss the opportunity of reaching these patients, the education should be more emphasized on CAM facilities.


Ono R,  Higashi T,  Suzukamo Y,  Konno S,  Takahashi O,  Tokuda Y,  Rhaman M,  Shimbo T,  Endo H,  Hinohara S,  Fukui T and  Fukuhara S. Higher internality of health locus of control is associated with the use of complementary and alternative medicine providers among patients seeking care for acute low-back pain. Clinical Journal of Pain. 24(8):725-30, Oct 2008.


The terminology of CAM and conventional healthcare approaches used throughout the medical profession is, in my opinion, a wholly artificial division and semantic anomaly. Whether a patient is treated with acupuncture or ultrasound, massage, osteopathy or physiotherapy, it certainly appears to be splitting hairs if one approach is labelled CAM and the other "western".

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