Questionnaire on the Current Status of Chronic Low Back Pain and Demand

Questionnaire on the Current Status of Chronic Low Back Pain and Demand for Acupuncture Treatment Among the Core Working-Age Population (25-54 years)

Research Center Number and Name：

01 Gansu University of Chinese Medicine Affiliated Hospital (China-Kyrgyzstan Traditional Chinese Medicine Center)02 Xi'an Hospital of Traditional Chinese Medicine for Brain Diseases Affiliated to Shaanxi University of Chinese Medicine (China-Kazakhstan Traditional Chinese Medicine Center);03 Kyrgyzstan National National Hospital04 Gansu University of Chinese Medicine Affiliated HospitalOther

1. Are you between 25 and 54 years old? [Single-choice question]

〇 yes〇 No

2.Have you experienced lower back pain that lasted for at least one day in the past year? (The area of pain refers to the back from near the belt to above the hips.)

YesNo

3. Have you had lower back pain for more than 3 months (12 weeks)? [Single-choice question]

yesNo

4.Have you been diagnosed by a doctor with chronic low back pain?

YesNo

Part 1: Informed Consent Statement

Dear Participant,Thank you for participating in this study! This research aims to understand the current status of chronic low back pain and the demand for acupuncture treatment among the core working-age population (25-54 years). Your responses will help us improve treatment services for patients with chronic low back pain.The main content of this survey includes:Basic information (such as age, economic status, treatment stage, etc.), disease characteristics, disease burden, treatment status, treatment needs and preferences, etc.

Privacy Protection:All data collected in this study will be strictly anonymized and used for scientific research only. Any information that can identify you personally will not be disclosed in the research results. Data will be stored in encrypted, protected systems.Your participation in this survey is completely voluntary, and you may withdraw at any time.

5.Consent Statement:

Yes, I agree to participate. I have read and understood the above information and voluntarily participate in this survey.No, I do not agree to participate in this survey. Thank you for your participation, the survey ends here.

Part 2: Basic Information

6.Gender

MaleFemale

7.Date of birth:

8. Country or region

Provinces/municipalities of ChinaKyrgyzstanKazakhstanUzbekistanTajikistanTurkmenistanOther

9. Nation:

Han nationalityUyghurKazakhHuiMongolianTajikManchuXibeUzbekEthnic RussiansDaur peopleTatarDongganKyrgyzBelarusianothers

10. Marital status [single-choice question]

UnmarriedMarriedDivorcedWidowedothers

11. Fertility status [single-choice question]

No childrenA childTwo childrenThree or more

12. Education [single-choice question]

Junior high school and belowHigh school/technical secondary schoolJunior collegeUndergraduateMaster's degree graduateDoctoral student

13. Occupation [single-choice question]

Occupations with high physical load (requiring frequent bending, twisting, lifting, or standing/walking for long periods)Moderately active occupations (jobs that require standing and walking but typically do not involve heavy physical labor)Sedentary office occupations (sitting for most of the time at work, such as in an office, driving)Hybrid or flexible occupations (work postures and activity levels are not fixed, or are arranged by individuals themselves)Non-employedOthers (please indicate) :

14. High Physical Load occupations [Single-choice question]

Construction workerPorter/LoaderFarmerForestry workerProduction line workerOther

15. Moderately active occupations

TeacherRetail/food servicestaffChef ElectricianPlumberDomestic helperothers

16. Sedentary office occupations

Administrative/clerkIT programmerAccountingDesignerCustomer ServiceBus/taxi driverBusiness managersothers

17. Hybrid mode or flexible career

Sales representative FreelancerArtistResearchersSome healthcare workersothers

18. Non-employed [single-choice question]

StudentFull-time parentCurrently not workingothers

19. Type of medical coverage (multiple choice) : [Multiple-choice question]

Medical insurance for urban employeesUrban and rural residents' medical insuranceCommercial insuranceOut of pocketothers

20. Personal average annual income (RMB for Chinese mainland, USD for other regions) :

RMB:Under 10,000 yuan10,000-20,000 yuan20,000-30,000 yuan30,000-50,000 yuan50,000 - 100,000yuanMore than 100,000 yuanDollar$:Under $1,000$1000- $3000$3000- $5000$5,000 - $10,000$10,000 - $20,000$20,000 or moreothers

21. History of smoking [single-choice question]

Never smokedQuit smokingSmokersothers

22. Years of smoking [fill-in-the-blank]

23. Years since quitting smoking [fill-in-the-blank question]

24. History of drinking [single-choice question]

Never drankAbstaining from alcoholDrinkersothers

25. Years of drinking [fill-in-the-blank]

26. Years of abstinence from alcohol (years) [fill-in-the-blank question]

27. Height (cm)

cm(120)

cm(220)

28. Weight (kg)

kg(20)

kg(200)

Part 3 of 3: Disease characteristics

29. Is there a definite cause for your lower back pain [single-choice question]

Yes.No

30. Is your lower back pain caused by any of the following spinal specific diseases?

Spinal infectionSpinal tumorsOsteoporosisSpinal fracturesLumbar disc herniationLumbar spinal stenosisSpinal deformityAnkylosing spondylitisothersNone

31. Is your lower back pain caused by any of the following neurological disorders?

Spinal cord tumorCauda equina tumorothers _________________*None

32. Is your lower back pain caused by any of the following visceral system disorders?

Urinary system diseasesGynecological diseasesothers _________________*None

33. Is your lower back pain caused by any of the following vascular system diseases?

Abdominal aortic dissection aneurysmothersNone

34. Is your lower back pain caused by any of the following psychogenic disorders?

DepressionHysteriaothersNone

35. How long have your lower back pain symptoms persisted? [Single-choice question]

Within 3 months3 months - 1 year1 to 5 yearsMore than 5 years

36. Intensity of pain: What was the average degree of pain in your lower back over the past week? (On a scale of 0 to 10, 0 for no pain and 10 for the most severe pain you can imagine)[single-choice question]

37. Frequency of pain: How many days did you experience lower back pain in the past month?[Single-choice question]

Almost every day3 to 5 days a week1-2 days a weekIt only happened 1-2 days

38. Do you have any discomfort in other parts of your body besides lower back pain? [Single choice question]

In the middle of the waist, there is a painful sensation when pressedOne side of the lower back with deep pain above the buttocksRadiating pain from the buttocks down the back of the thighLower back pain with pain on the outer side of the legLower back pain with pain in the groin area or the front of the thighGeneralized soreness and stiffness in the lower back, especially in the morningOthersNone

39. Nature of lower back pain: [multiple-choice question]

Dull painSorenessStabbing painBurning painDistending painTendernessRadiating painA tingling sensation/electric shock sensationPulling sensation/tightness sensationCramping painDeep throbbing painothers

40. Causes of lower back pain (multiple choice) : [multiple choice]

Lumbar muscle strainTrauma to the waistWorking environmentLiving environmentDefinite primary illnessNo obvious causeothers

41. Symptoms associated with low back pain: [multiple-choice question]

Abnormal sensation in the lower extremitiesAbnormal local sensationMuscle spasmNoneothers

42. Causes of aggravated lower back pain (multiple choice) :

Sitting or standing for long periods Cold, damp and other environmental factors Heavy physical labor Changes in time such as morning, night, etc Coughing and sneezing No obvious cause others

43. Reasons for relief of lower back pain (multiple choice):

No obvious causeRestA little activityWestern medicine treatmentTraditional Chinese Medicine treatmentThermotherapy (such as hot compress)AcupunctureMassageOther non-pharmacological treatments

Part 4 of 4: Disease burden

44. Functional activity impact: To what extent has your lower back pain affected your daily activities (such as housework, shopping, personal care, etc.) over the past month? (0 means no effect at all, 10 means completely unable to perform daily activities) [single-choice question]

45. Work Impact: How much does your lower back pain affect your work? (Fill in for working people) [Single-choice question]

No effectMild impact (occasionally reduced efficiency, but still able to complete all tasks)Moderate impact (frequently reduced efficiency, requiring reduction or adjustment of some tasks)Severe impact (having taken more than 30 days off due to back pain in the past year, or having to change positions)Extreme impact (Unemployment or inability to work due to low back pain)

46. Financial Burden: Is your lower back pain a financial burden for you? (Including out-of pocket medical treatment, medication, rehabilitation equipment, transportation and reduced income due to absence from work, etc.) [single-choice question]

No financial burdenLight burden (extra spending less than 5% of the household 's annual income)Moderate burden (extra spending of 5%-10% of the household 's annual income)Heavy burden (extra spending more than 10% of annual household income)

47. Psychological and emotional impact: Does low back pain often bring you negative emotions (such as anxiety, depression, irritability or low mood)? [Single-choice question]

NeverOccasionally (a few times a month)Often (a few times a week)Always (almost every day)

Part 5 of 5: Treatment situation

48. Have you received any of the following treatments for chronic low back pain within the last month? [Single-choice question]

YesNo

49. Western medicine treatment (multiple choice, and rate satisfaction with the therapy used, 0= very dissatisfied, 10= very satisfied)

Topical medications (such as flurbiprofen gel patches, etc.)Non-steroidal anti-inflammatory drugsParacetamolOpioidsMuscle relaxantsLocal injection (such as hormone or anesthesia, etc.)Minimally invasive surgeryOther Western medical treatmentsNot treated with Western medicine

50. Chinese medicine (multiple choices are acceptable, and satisfaction ratings are given for the therapy used, 0= very dissatisfied, 10= very satisfied) [multiple-choice question]

Acupuncture (commonly known as moxibustion)Electroacupuncture (where a microcurrent is attached to an acupuncture needle to enhance stimulation)Small needle knifeMassageGua shaMoxibustionCuppingExternal application of traditional Chinese medicinePlaster applicationTake Chinese medicineOther traditional Chinese medicine treatmentsNo traditional Chinese medicine treatment

51. Rehabilitation treatment (multiple choice, and rate satisfaction with the therapy used, 0= very dissatisfied, 10= very satisfied) [multiple-choice question]

exercise therapy (aerobic training, active stability training, yoga, traction, tai chi, etc.)treatment of physical factors (such as ultrasonic treatment, percutaneous nerve electrical stimulation, laser treatment, etc.)Braces and plantar orthopedic padsCognitive behavioral therapyOther rehabilitation therapies (exercise taping, mindfulness-based stress reduction training)No rehabilitation treatment

Part 6: The need for acupuncture treatment for low back pain

52. Have you ever received acupuncture or electroacupuncture treatment for your lower back pain in the past? [Single-choice question]

Both acceptedOnly received acupunctureOnly received electroacupunctureNever received anything

53. Now that you have experienced both methods, would you like to continue using them in the future? [Multiple-choice question]

Willing to continue with acupuncture treatment Unwilling to continue acupuncture treatment Unsure whether to continue with acupuncture treatment Willing to continue with electroacupuncture treatment Unwilling to continue electroacupuncture treatment Unsure if they would like to continue with electroacupuncture treatment

54. Based on your past experience with acupuncture, would you like to receive the following treatments in the future? [Single-choice question]

Willing to continue with acupuncture treatmentUnwilling to continue with acupuncture treatmentNot sure if you want to continue with acupuncture treatment

55. Would you like to try electroacupuncture treatment that you have never experienced before?[Single-choice question]

Willing to try electroacupuncture treatmentUnwilling to try electroacupuncture treatmentNot sure if you would like to try electroacupuncture

56. Based on your past experience with electroacupuncture, would you like to receive the following treatments in the future? [Single-choice question]

Willing to continue with electroacupuncture treatmentUnwilling to continue electroacupuncture treatmentNot sure if you want to continue with electroacupuncture treatment

57. Would you like to try acupuncture treatment that you have never experienced before?[Single-choice question]

Willing to try acupuncture treatmentUnwilling to try acupuncture treatmentNot sure if you would like to try acupuncture

58. Why haven't you received acupuncture or electroacupuncture treatment? [Multiple-choice question]

Worry about poor efficacy Concerns about safety Worried about the high cost of treatmentI've never heard of acupuncture or electroacupuncture therapy Not interested in acupuncture or electroacupuncture therapy An instinctive rejection of "needles" and "electricity" others

59. Since you have never received either of these treatments, would you like to try them?[Multiple-choice question]

Willing to try acupuncture treatment Unwilling to try acupuncture treatment Not sure if you would like to try acupuncture Willing to try electroacupuncture Unwilling to try electroacupuncture Not sure if you would like to try electroacupuncture

60. What approach do you tend to choose as the main treatment for low back pain? [Single choice question]

AcupunctureElectroacupunctureOther therapies besides acupuncture/electroacupunctureDepending on the situation/Follow your doctor's advice

61. If you were to treat your lower back pain with acupuncture or electroacupuncture, how confident would you be in such treatments? [Single-choice question]

1 (No confidence at all)

5(Full of confidence)

62. If you were treated with acupuncture or electroacupuncture for your lower back pain, how many weeks of treatment would you accept at most?[Single-choice question]

1 week2Weeks3Weeks4Weeks6 WeeksMore than 6 weeks

63. If your lower back pain is treated with acupuncture or electroacupuncture, what is the maximum number of treatments you can receive per week? [Single-choice question]

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