Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management

Gülçin Babaoğlu; Tolga Kaplan; Şükriye Dadalı; Ali Çoştu; Yavuz Akçaboy

Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management

Abstract

Aims: Chronic low back pain (CLBP) remains one of the leading contributors to years lived with disability globally, and guideline-based care increasingly emphasizes non-pharmacological treatments (NPTs) as first-line management. This study aimed to characterize real-world patterns of NPT utilization before tertiary pain-clinic presentation in patients with CLBP and to examine associated treatment perceptions and barriers. Methods: This single-center, cross-sectional analytical study enrolled 150 consecutive adults with chronic low back and/or leg pain. Data were collected by pain specialists using a structured clinical form covering sociodemographic characteristics, pain characteristics, prior NPT exposure, treatment continuity, Global Perceived Effect (GPE), and barriers to care. Descriptive statistics and appropriate comparative tests were used for analysis, with statistical significance defined as p<0.05. Multivariable logistic regression was performed to identify independent predictors of NPT utilization and discontinuation. Results: Of 150 patients, 97 (64.7%) attempted at least one NPT before referral. Physical therapy was most common (81.4%), followed by exercise (41.2%) and transcutaneous electrical nerve stimulation (TENS) (34.0%). Notably, no participants reported utilization of cognitive behavioral therapy (CBT) or hypnosis. Among NPT users, 29.9% discontinued treatment prematurely; lack of perceived benefit was the most frequent reason. Mean GPE scores were similar across modalities (4.44-4.67). The most prominent barriers were low motivation and insufficient information/guidance, whereas cost was the least prominent. Multivariable logistic regression identified higher appointment access barrier scores as the only significant predictor of lower treatment discontinuation among NPT users (p=0.03). Pain duration showed a trend toward lower dropout odds (p=0.13) that did not reach statistical significance. No individual factor significantly predicted NPT utilization in the adjusted model. Conclusion: In this tertiary referral cohort, NPT exposure was frequent but often narrow in scope, insufficiently multimodal, and prone to early discontinuation. Strengthening referral pathways, patient education, and adherence support may improve implementation quality before escalation to invasive interventions.

Keywords

Supporting Institution

This study did not receive financial support from any institution.

Ethical Statement

The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethical approval was obtained from the Ankara Bilkent City Hospital Medical Research Scientific and Ethical Review Committee (Date: 19.11.2025, Decision No: TABED 1-25-1874). Written informed consent was obtained from all participants.

Thanks

None

References

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Details

Primary Language

English

Subjects

Pain

Journal Section

Research Article

Authors

Gülçin Babaoğlu ^*
0000-0002-1461-4092
Türkiye

Tolga Kaplan
0000-0001-9289-407X
Türkiye

Şükriye Dadalı
0000-0003-4204-4530
Türkiye

Ali Çoştu
0000-0003-4383-0146
Türkiye

Yavuz Akçaboy
0000-0002-9962-2090
Türkiye

Publication Date

May 22, 2026

Submission Date

March 9, 2026

Acceptance Date

May 21, 2026

Published in Issue

Year 2026 Volume: 8 Number: 3

IZ

https://izlik.org/JA46UY37BP

Cite

RIS / Bibtex

APA

Babaoğlu, G., Kaplan, T., Dadalı, Ş., Çoştu, A., & Akçaboy, Y. (2026). Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management. Anatolian Current Medical Journal, 8(3), 569-575. https://izlik.org/JA46UY37BP

AMA

1.Babaoğlu G, Kaplan T, Dadalı Ş, Çoştu A, Akçaboy Y. Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management. Anatolian Curr Med J / ACMJ / acmj. 2026;8(3):569-575. https://izlik.org/JA46UY37BP

Chicago

Babaoğlu, Gülçin, Tolga Kaplan, Şükriye Dadalı, Ali Çoştu, and Yavuz Akçaboy. 2026. “Patterns of Non-Pharmacological Treatment Utilization in Patients With Chronic Low Back Pain Referred for Interventional Pain Management”. Anatolian Current Medical Journal 8 (3): 569-75. https://izlik.org/JA46UY37BP.

EndNote

Babaoğlu G, Kaplan T, Dadalı Ş, Çoştu A, Akçaboy Y (May 1, 2026) Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management. Anatolian Current Medical Journal 8 3 569–575.

IEEE

[1]G. Babaoğlu, T. Kaplan, Ş. Dadalı, A. Çoştu, and Y. Akçaboy, “Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 3, pp. 569–575, May 2026, [Online]. Available: https://izlik.org/JA46UY37BP

ISNAD

Babaoğlu, Gülçin - Kaplan, Tolga - Dadalı, Şükriye - Çoştu, Ali - Akçaboy, Yavuz. “Patterns of Non-Pharmacological Treatment Utilization in Patients With Chronic Low Back Pain Referred for Interventional Pain Management”. Anatolian Current Medical Journal 8/3 (May 1, 2026): 569-575. https://izlik.org/JA46UY37BP.

JAMA

1.Babaoğlu G, Kaplan T, Dadalı Ş, Çoştu A, Akçaboy Y. Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management. Anatolian Curr Med J / ACMJ / acmj. 2026;8:569–575.

MLA

Babaoğlu, Gülçin, et al. “Patterns of Non-Pharmacological Treatment Utilization in Patients With Chronic Low Back Pain Referred for Interventional Pain Management”. Anatolian Current Medical Journal, vol. 8, no. 3, May 2026, pp. 569-75, https://izlik.org/JA46UY37BP.

Vancouver

1.Gülçin Babaoğlu, Tolga Kaplan, Şükriye Dadalı, Ali Çoştu, Yavuz Akçaboy. Patterns of non-pharmacological treatment utilization in patients with chronic low back pain referred for interventional pain management. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 May 1;8(3):569-75. Available from: https://izlik.org/JA46UY37BP