Treatment preferences among Canadian military Veterans with chronic low back pain: Mixed-methods cross-sectional survey

Patients are more willing to accept treatments that match their preferences. The authors conducted a survey to find out what treatments military Veterans prefer for low back pain. The survey, which asked about experiences with low back pain and attitudes toward health care providers and treatments, reached 1,632 Canadian Armed Forces (CAF) Veterans, and 290 with chronic low back pain completed it. Most respondents said they had lived with low back pain for five or more years. A total of 91% began experiencing pain during military service. The health care providers most preferred to treat chronic low back pain were massage therapists, physiotherapists, family physicians, and chiropractors. Preferences were based on how well treatments worked, how much Veterans trusted the provider, and how accessible the care was. Most respondents said registered massage therapy, physiotherapy, chiropractic, and occupational therapy should be available on military bases for actively serving members of the CAF. Findings about the treatment preferences of military personnel should inform future research and policies to improve management of low back pain among serving CAF members and Veterans. Introduction: Patients are more willing to initiate and engage in treatments they are predisposed toward; however, Canadian military Veterans' preferences for managing low back pain are uncertain. This study examined Canadian military Veterans' use of, and preferences for, health care providers for managing chronic low back pain, both while serving and after release. Methods: A 33-item survey was emailed, in English and in French, to 1,632 Canadian Armed Forces (CAF) Veterans in February-May 2023. CAF Veterans living with chronic low back pain were eligible to complete the survey, which asked about demographic variables, military service, chronic-low-back-pain-related characteristics, and experiences and attitudes toward health care providers and therapeutic approaches to chronic low back pain. Results: Of 1,632 individuals, 290 returned a completed survey (18% response rate). Almost all (98%) who responded reported living with chronic low back pain for more than 5 years, and 91% indicated first experiencing low back pain during military service. Among 12 health care provider options for managing chronic low back pain, respondents most preferred massage therapists, physiotherapists, family physicians, and chiropractors. The most-attended off-base practitioners for low back pain while serving in the military were physiotherapists (39%), chiropractors (35%), and registered massage therapists (30%). Most respondents endorsed that registered massage therapy (70%), physiotherapy (60%), chiropractic care (51%), and occupational therapy (50%) should be available on base for serving military personnel. Discussion: Findings suggest there may be opportunities to better align on-base health care for low back pain with military personnel's evidence-based treatment preferences. Introduction : Les patient(e)s sont plus enclin(e)s & agrave; entreprendre et suivre des traitements auxquels ils et elles sont pr & eacute;dispos & eacute;(e)s, mais on ne conna & icirc;t pas les pr & eacute;f & eacute;rences des v & eacute;t & eacute;ran(e)s militaires du Canada & agrave; l'& eacute;gard de la gestion des douleurs lombaires. Cette & eacute;tude a port & eacute; sur l'utilisation et les pr & eacute;f & eacute;rences des v & eacute;t & eacute;ran(e)s militaires canadien(ne)s & agrave; l'& eacute;gard des travailleur(se)s de la sant & eacute; qui g & egrave;rent leurs douleurs lombaires chroniques pendant qu'ils et elles & eacute;taient en service et apr & egrave;s leur lib & eacute;ration. M & eacute;thodologie : Au total, 1 632 v & eacute;t & eacute;ran(e)s des Forces arm & eacute;es canadiennes (FAC) ont re & ccedil;u un sondage de 33 questions par courriel, en anglais et en fran & ccedil;ais, entre f & eacute;vrier et mai 2023. Les v & eacute;t & eacute;ran(e)s des FAC qui vivaient avec des douleurs lombaires chroniques & eacute;taient admissibles au sondage, qui contenait des questions sur la d & eacute;mographie, le service militaire, les caract & eacute;ristiques des douleurs lombaires chroniques et les exp & eacute;riences et attitudes envers les travailleur(se)s de la sant & eacute;, ainsi que les approches th & eacute;rapeutiques des douleurs lombaires chroniques. R & eacute;sultats : Des 1 632 personnes sond & eacute;es, 290 ont remis un sondage rempli (taux de r & eacute;ponse de 18 %). Presque toutes celles qui ont r & eacute;pondu (98 %) ont affirm & eacute; vivre avec des douleurs lombaires depuis plus de cinq ans, et 91 % ont indiqu & eacute; avoir ressenti leurs premi & egrave;res douleurs lombaires pendant leur service militaire. Sur les 12 possibilit & eacute;s de travailleur(se)s de la sant & eacute; pour g & eacute;rer les douleurs lombaires chroniques, les r & eacute;pondant(e)s pr & eacute;f & eacute;raient surtout les massoth & eacute;rapeutes, les physioth & eacute;rapeutes, les m & eacute;decins de famille et les chiropraticien(ne)s. Les physioth & eacute;rapeutes (39 %), les chiropraticien(ne)s (35 %) et les massoth & eacute;rapeutes autoris & eacute;(e)s (30 %) & eacute;taient les praticien(ne)s les plus consult & eacute;(e)s hors de la base militaire pour soigner des douleurs lombaires pendant le service militaire. La plupart des r & eacute;pondant(e)s trouvaient que la massoth & eacute;rapie autoris & eacute;e (70 %), la physioth & eacute;rapie (60 %), la chiropraxie (51 %) et l'ergoth & eacute;rapie (50 %) devraient & ecirc;tre offertes au personnel militaire en service sur la base militaire. Discussion : Selon les observations, il y a peut-& ecirc;tre des occasions de mieux harmoniser les soins offerts sur la base militaire pour traiter les douleurs lombaires avec les pr & eacute;f & eacute;rences th & eacute;rapeutiques fond & eacute;es sur des donn & eacute;es probantes des patient(e)s.