Complementary and Integrative Health Approaches for Low Back Pain in Veterans: A Narrative Review.

Area of Science:

• Integrative medicine and pain management research.
• Veteran health and healthcare policy.

Background:

• Chronic low back pain (cLBP) significantly impacts veterans' quality of life and contributes to opioid dependence.
• Complementary and integrative health (CIH) offers non-pharmacological alternatives for pain management, potentially improving outcomes and reducing healthcare costs.

Purpose of the Study:

• To synthesize evidence on CIH for veterans with cLBP.
• To evaluate CIH's impact on pain, function, well-being, and opioid use.
• To identify barriers and priorities for implementing CIH within the VA health system.

Main Methods:

• A narrative synthesis of peer-reviewed literature from 2010-2025, focusing on veteran-specific studies.
• Inclusion of systematic reviews, RCTs, observational studies, and evidence maps.
• Analysis guided by a patient-centered, biopsychosocial, and whole-health framework.

Main Results:

• CIH evidence in veterans is limited but promising; battlefield acupuncture showed significant pain reduction.
• Yoga, Tai Chi, Qigong, and mindfulness offered modest improvements; CBT, chiropractic, and massage had mixed results.
• Multimodal CIH integrated with conventional care demonstrated the strongest outcomes, including reduced opioid prescriptions and improved coping.

Conclusions:

• CIH strategies are patient-centered and holistic, with potential to reduce pain and opioid reliance in veterans.
• Standardized implementation and veteran-specific trials are needed to strengthen evidence for sustainable integration into the VA health system.