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Journal of Alternative and Complementary Medicine

Table 4.

Themes with Example Quotes

Options/hope:“Has helped me to be more open to other alternatives instead of pills.”
 “I was skeptical of needles being poked in various parts of my body having any effect on problems in my body. I was surprised when I actually felt relief [and] improvement.”
 “I now believe in alternative therapies, where I didn't before.”
 “It made a believer out of me, where the massage can lessen the pain in my back. It gave me a lot of hope that the pain was manageable, I thought of it as something that was always there.”

Relaxation:“It helps to relax my entire being through the breathing exercises that I learned. So when I get tired, stressed, whatever, I can remember to breathe and I know I'll be OK.”
 “It relaxed me. It made me feel better physically and emotionally.”
 “I got total relaxation and awareness, self-consciousness of my problem with my back. Learning to relax my body … it's wonderful, fabulous.”

Emotional state:“It was great, it had a great effect on me. I can say as far as stress, overall mental health it was incredible, it was wonderful. I wish I could say it did as much for my lower back pain as it did for my mental health, although it did help a little with my lower back pain, the ability to help with stress did help a lot.”
 “My attitude toward self and others has changed. I have more self control and [am] no longer angry or mad. I am more sociable and spend more quality time with my daughter. More physical activities and stretch out more. Life is good again … Thank you. Acupuncture has changed my life. It was good for me. I'm happy and now feel young again. I can now do things I could not have done in the past, because of fear of injury and because of all the pain I had.”

Body awareness:“It has to do with a focus on WHERE in the back the pain is located—it made me think of the pain on my back as a whole SYSTEM, actually the entire back of my body, including my legs—which I'd not experienced or thought of before. Previously I perceived just my BACK pain, but my whole body is part of the pain.”
 “It has created an awakening for me, for my empowerment and my ability to manage my own physicality. It has helped with increasing levels of concentration, relaxation, and breathing. [It has] created focus. I would call it life-changing.”
 “Having an increased awareness of my body—different body parts in relation to other body parts, like in lifting—bending, balancing movements. [Doing] the breathing exercises I had an epiphany—pushing out air from below the waist when you exhale—made me realize I could take fuller and deeper breaths. The end of the class—the wind-down time, let me carry that feeling of calm and peace with me and apply it to other situations. I could lessen the impact of stress by stepping outside of it, in a part of myself.”

Change in thinking and awareness:“The treatments made me realize that perception of pain doesn't indicate there's a problem.”
 “ … I realized I need to take more personal time for me. It doesn't matter if that is exercise, or sitting still. It means that I need to not be dad or husband—I need to be just me. The lifestyle change was key. It was a mental change. It brought a smile to my health. It was a change in consciousness. A better sense of self and personal responsibility.”
 “It got me to think about my back and how I've isolated it as a problem separate from the rest of my life. I've been able to deny I had pain and it got me to see that.”
 “I'm a skeptic and empiricist, but it's been just interesting for me to consider the possibilities and maybe the one thing [the CAM provider] has reinforced for me is that your mind is a very powerful thing and if you focus your mind in the right directions, good things can come of it. I have moments where I came back into a kind of awareness of what real relaxation and pleasure is.”

Well-being:“It helps with the back pain and also to sleep better, and brings peace too.”
 “I thought it contributed to an overall sense of well-being.”

Other:“Acupuncture has opened my eyes to a new way of treatment that has relieved not only pain but produced full body energy after the treatments.”
 “I thought my back pain would progressively get worse for the rest of my life. Now I know after having acupuncture it will become better for the rest of my life … I swing out of bed in the morning now. I'm the first one out of bed. No more pain in my knee—I can go though [my] exercise routine without pain. My life has totally changed for the good.”
 “It has improved not only my low back pain but my overall health in general. It's bolstered my immune system considerably. I'm predisposed to colds—I've felt healthier since starting the treatment. I've had no colds at all, and I am doing nothing different except for massage.
 “It has opened an extremely wide door—it's a catalyst … .Kabat-Zinn has very effectively shown the connection mind–spirit–body. To me this holistic approach is very fascinating. I do not doubt in future I will find more energy to deepen my knowledge about yoga, to be more regular in the exercise … It is essential for me … It's an energy booster on every level … ”
 “I've started thinking more outside the box—I used to think you just go to the doctor; now I think there's more I can do, like trying yoga and trying to figure out what's causing the pain and what I can do to get it to stop. I used to expect the doctor to pull out some magic procedure, but they would just give me a prescription; now I try to figure it out and do more about it.”
 “Trying to be in the present moment helps a lot. Trying to look at things, observing without judgment is helpful. Stretching movements have been helpful, and being aware of the breath.”