Abstract
BACKGROUND: Acupuncture is used globally as an alternative treatment for patients with low back pain (LBP), effectively reducing pain and improving physical activity. However, the use and profile of acupuncture for LBP in middle-aged and older adults remains understudied. The aim of this study was to identify key factors associated with the use of acupuncture treatment in this population. METHODS: Using the 2018 China Health and Retirement Longitudinal Study (CHARLS) dataset, a cross-sectional analysis of 7,929 respondents aged 45 years and older with LBP was conducted. A two-way stepwise regression model was used to identify significant correlates of demographics, health status, and healthcare choice factors with acupuncture use, and multiple theory-driven interaction terms were introduced into the stepwise model and assessed for their enhancement of model fitting and predictive performance by likelihood ratio tests with AUC comparisons. In addition, stratified analyses by gender, age (45-59, 60-74, and ≥ 75 years), and residence were conducted to verify the stability of the model findings. RESULTS: Among 7,929 respondents with LBP from the CHARLS 2018 dataset, 1,097 (13.8%) comprised the acupuncture group while 6,832 (86.2%) formed the non-acupuncture group. Significant correlates included females (OR = 1.28, 95% CI: 1.09-1.49), pain distress level (OR = 1.54, 95% CI: 1.32-1.78), massage (OR = 8.81, 95% CI: 7.53-10.32), herbal medicine (OR = 2.65, 95% CI. 95% CI: 2.28-3.09), western medications (OR = 1.92, 95% CI: 1.65-2.24). CONCLUSION: LBP patients with certain characteristics tend to use complementary and alternative interventions, including acupuncture. In the future, it is necessary to combine the evaluation of efficacy and mechanism studies to clarify the optimal combination of multimodal treatment and the applicable population, in order to promote the use of acupuncture in the treatment of LBP.