The objective of this very interesting qualitative study by Stomski et al (2013) was to explore the experience of Acupuncture care from the perspective of people with chronic low back pain. For a change we are given some very interesting information about how our patients perceive, feel about and interpret Acupuncture treatment as opposed to simply focussing on objective outcome measures such as pain scores etc.
As a quick aside, for those of you who have not already read Peter O’Sullivan’s paper discussing the need to reevaluate how we manage chronic low back pain, I’d thoroughly recommend doing so given its relevance to this article
As a clinician who uses Acupuncture partly as a facilitatory technique, one which allows us to more easily influence unhelpful thoughts and behaviours relating to pain, such a study can provide useful information to help guide us based on the patients subjective experience.
The authors conducted in depth interviews with 11 chronic low back pain sufferers. Coding techniques were used to identify a core strategy of ‘reclaiming control’ as well as other categories such as ‘gaining sanctuary’’, ‘gaining trust’ and ‘working together’.
These categories reflected how the participants felt about entering an aesthetically appealing, calm and relaxing space; developing confidence in the acupuncturists’ ability to care for them; and negotiating strategies and sharing decision-making with Acupuncturists about their care.
As a Physiotherapist practicing Acupuncture, I was pleased to have the value of an aesthetically appealing, calm and relaxing space emphasised by the authors, ‘soft’ touches which I always try to create for my patients to good effect.
The authors concluded that “Clinicians using acupuncture as a management strategy for low back pain may elicit an immediate sense of calmness in patients with subsequent well-being benefits. A sense of calmness may also be enhanced through providing a relaxing physical environment. The transactional and interpersonal processes of establishing trust and rapport and shared decision-making are important for clients. Shared decision-making can be improved by clinicians by carefully considering the explanation of issues and plans to a particular patient, especially by developing an understanding of each patient’s worldview and using language that suits each individual’s healthcare orientation”.
These conclusions again emphasise the importance of context and patient communication, key ingredients in the therapeutic relationship. My view of Acupuncture as a tool to help me achieve certain treatment goals, one of which is to help calm, relax and reveal more rational thought processes in relation to pain is supported by the study.