Musculoskeletal pains are prevalent among Veterans. Complementary and integrative health (CIH) therapies are important non-pharmacologic treatment options for pain and its comorbid conditions. As such, CIH provision and research in the VA are now mandated in Subtitle C of the Comprehensive Addiction and Recovery Act (CARA) of 2016. Many providers encourage patients to take a more active role in their pain treatment by using self-care practices such as meditation/mindfulness, Tai Chi and yoga instead of relying solely on practitioner-delivered treatment such as acupuncture or chiropractic care.

A critical question for the field is whether adding this type of self-care strategy to practitioner-delivered CIH increases effectiveness in the treatment of pain. However, very few have examined the comparative effectiveness of practitioner-delivered CIH versus CIH self-care, and almost none have explored the pressing question of whether adding self-care to practitioner-delivered CIH is a more effective approach than either strategy alone. This question is of particular importance to the VA as it moves forward in developing policies and processes on the implementation of both practitioner-delivered CIH care as well as dissemination strategies for Veterans to learn self-care approaches.