What does this research mean for the field?

Veterans with chronic musculoskeletal pain who use acupuncture, with or without movement therapies, incur higher downstream imaging costs and have more imaging visits than those receiving only conventional care. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to assess how acupuncture and movement therapies affect imaging costs for Veterans with chronic musculoskeletal pain.

July 11, 2026Acupuncture in Medicine0 citations

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Evaluation of acupuncture, movement therapies and imaging costs among Veterans with chronic musculoskeletal pain

SFStephen FrochenUniversity of California, Los Angeles STSCS TaylorUniversity of California, Los Angeles SCScott CoggeshallVA Puget Sound Health Care System

Key Points

The aim is to assess how acupuncture and movement therapies affect imaging costs for Veterans with chronic musculoskeletal pain.
Utilized VA electronic health record data from 2018 to 2022.
Employed propensity score modeling and nearest neighbor matching for treatment allocation.
Compared imaging costs across two therapy exposure groups: acupuncture and movement therapies versus conventional care.
Veterans receiving acupuncture with movement therapies had $140 higher imaging costs (95% CI $97-$183) than conventional care.
Veterans using acupuncture without movement therapies experienced $155 higher imaging costs (95% CI $147-$163).
A higher number of imaging visits was also observed among both acupuncture groups.

Abstract

OBJECTIVE: Some complementary and integrative health (CIH) therapies are recommended for the management of chronic musculoskeletal pain, but little research has evaluated how these alternatives affect downstream healthcare utilization, including imaging costs. METHODS: Using US Department of Veterans Affairs (VA) Veterans Health Administration electronic health record data, we conducted propensity score modeling, allocating 2, 215, 231 Veterans with chronic pain using the VA from 2018 to 2022 into two therapy exposure groups - acupuncture with and without movement therapies (yoga or Tai Chi/Qigong) - compared with conventional care, or primary care management alone, to examine differences in imaging costs during a 6-month period following indexing. We calculated the probability of treatment in either exposure group based on demographic and clinical characteristics, and applied a nearest neighbor matching algorithm for subsequent estimation of average treatment effects. RESULTS: Veterans using acupuncture with or without movement therapies had sizable baseline clinical needs and healthcare utilization. After matching, we found that imaging costs and visits were higher among Veterans using acupuncture with CIH movement therapies (cost difference 140, 95% confidence interval (CI) 97-183; visit difference 0. 37; 95% CI 0. 30-0. 45) and without CIH movement therapies (cost difference 155, 95% CI 147-163; visit difference 0. 34; 95% CI 0. 33-0. 35) during the 6-month follow-up period, compared with those using conventional care. CONCLUSION: Veterans using acupuncture with or without CIH movement therapies had greater imaging costs than those using conventional care, possibly reflecting higher usage of healthcare among integrative therapy patients. These results also suggest unobserved patterns of comorbidity, recovery or access and/or radiology inefficiencies leading to an imaging loop effect as potential considerations for future investigation.

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Evaluation of acupuncture, movement therapies and imaging costs among Veterans with chronic musculoskeletal pain

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