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Predictors of Willingness to Engage in Acupressure Treatment for Chronic Low Back Pain

P-060 - (Poster #60) Predictors of Willingness to Engage in Acupressure Treatment for Chronic Low Back Pain

Thursday, September 4, 2025
4:00 PM - 5:30 PM PST
Location:  Exhibit Hall (Level 4)

    Author/Presenter(s)

  • AM

    Alec McKheen, BS

    Medical Student
    Michigan State University College of Human Medicine
    Grosse Ile Township, Michigan

  • JP

    Jennifer Pierce, PhD

    Research Assistant Professor
    University of Michigan
    Ann Arbor, Michigan

  • CZ

    Caroline Zubieta, MD, MBA

    Resident
    University of Michigan Department of Anesthesiology
    Ann Arbor, Michigan

  • GZ

    Guohao Zhu, PhD

    Research Investigator
    University of Michigan
    Ann Arbor, Michigan

Background: Chronic low back pain (cLBP) affects approximately 13.1% of U.S. adults1 and is increasing in prevalence and associated disability2, indicating a need for more effective treatments. Multimodal approaches, typically beginning with conservative therapies (physical and cognitive) and progressing to pharmacological or procedural options when necessary, often fail to provide adequate relief3,4. Alternative treatments, such as acupressure, acupuncture, massage, and yoga, show promise as supplemental therapies. However, research on alternative therapies is limited, and research on acupressure is especially sparse compared to other alternative therapies. Preliminary results have suggested acupressure to be safe and effective option in pain management5.

Patients with cLBP have shown a willingness to use alternative therapies to treat their pain when necessary6,7, but willingness tends to vary across modalities. Furthermore, the relationship between willingness to engage in treatments and treatment effectiveness is unclear in other alternative treatments, with some studies finding an association8.9 while other studies do not10. 
Identifying which patients are most likely to express interest in using acupressure to treat cLBP is crucial for effective treatment implementation and may have downstream effects on treatment effectiveness. Patient demographics and pain characteristics may be valuable predictors that provide insights into providing patient-specific interventions that enhance patient outcomes.


Purpose/Objectives: The purpose of this study was to investigate which patient demographics and pain characteristics are associated with willingness to engage in acupressure treatment for cLBP.

Methods:

Patients (n = 405; Mage = 52.48, SD= 16.93; 72% Female; 47% White) who had recently visited Family Medicine or the Back & Pain Center clinics at Michigan Medicine were sent an email to participate in a cross-sectional online survey. Participants self-reported age, gender identity, race, income, education, prior acupuncture use, and willingness to engage in acupressure to treat cLBP. Additionally, participants completed the PROMIS-29+2 questionnaire to gauge the impact of pain across seven domains of daily life: physical function, anxiety, depression, fatigue, sleep disturbance, social participation, pain interference, and cognitive function. 



Univariable (each predictor evaluated in separate models) and multivariable (including all predictors in a single model) ordinal logistic regressions were utilized to predict willingness to use acupressure to treat cLBP. Pairwise correlations were assessed between the set of predictors. Pain interference residuals were utilized for the predictive models to address concerns related to multicollinearity. Past use of acupuncture was omitted from the multivariable model. R was used for analyses.



Results: Univariable models suggest that female gender (OR = 1.70, p = .041), college education (OR = 1.58, p = .037), past use of acupuncture (OR = 2.29, p = .011), and higher pain interference (OR = 2.09, p = .001) were associated with greater willingness to utilize acupressure, whereas Black race (vs. White race; OR = .46, p = .003) was associated with lower willingness.  The multivariable model suggests that Black race (vs. White; OR = .40, p = .008) and other race (vs. White; OR = .47, p = .021) were associated with lower willingness to utilize acupressure, whereas higher pain interference was associated with greater willingness to utilize acupressure (OR = 1.85, p = .027) in the context of all predictors.

Conclusions/Implications for future research and/or clinical care:

Female gender, White race, college education, and higher pain interference were associated with greater willingness to engage in acupressure treatment to treat cLBP. This implies that patient demographics may be more associated with willingness to try alternative therapies, specifically acupressure, to treat cLBP, than pain characteristics, aside from pain interference. Previous research also shows higher pain interference scores correlating with an increased patient willingness to engage in alternative therapies, possibly out of desperation. Interestingly, there was no association found between impairment in domains of daily functioning and willingness to use acupressure to treat cLBP. 



Results from this study can be used to inform clinicians which subset of patients may be more willing to incorporate acupressure into a multimodal approach to treat cLBP. Future research should further investigate the effectiveness of acupressure as a treatment and if there are any variables that increase the effectiveness of acupressure to treat pain.