Knowledge, Attitudes, and Preferences Regarding Acupuncture for Chronic Pain among Sri Lankan Adults: A Cross-Sectional Online Survey

Background: Acupuncture has gained attention as a complementary approach to chronic pain management, with clinical evidence demonstrating benefits across various chronic pain conditions. However, its acceptance and utilisation may be influenced by patients' knowledge, perceptions and expectations regarding the intervention. Objective: To assess the knowledge, attitudes, and preferences of Sri Lankan adults regarding the utilisation of acupuncture for chronic pain management and to examine their associations with sociodemographic characteristics. Methods: A cross-sectional study was conducted among participants aged 18 years or older. Data were collected using a self-administered questionnaire divided into four sections: demographics, knowledge, attitudes, and preferences. Knowledge was categorised using Bloom’s cut-off criteria. Group comparisons were conducted using t-tests, ANOVA with Tukey HSD post hoc tests, and Monte Carlo permutation tests for categorical associations. Results: Among 468 complete responses, the mean age was 34.5 years (SD 12.9) and 282 respondents (60.3%) were women. Good, moderate and poor knowledge categories included 144 (30.8%), 246 (52.6%) and 78 (16.7%) respondents, respectively. Acupuncture was correctly identified as a potential chronic-pain treatment by 360 respondents (76.9%), whereas 306 (65.4%) incorrectly believed that it applied to every medical condition. A total of 366 respondents (78.2%) considered acupuncture generally safe and 360 (76.9%) supported its availability in mainstream hospitals. A strong overall preference was recorded for 192 respondents (41.0%), and 258 (55.1%) selected the highest preference level for hospital integration. Knowledge scores differed significantly by gender, age, ethnicity, education and income (all p < .001). Preference scores differed by age, education, income and civil status, but not by gender or ethnicity. Knowledge and preference were weakly positively related (R² = 0.138). Conclusions: The study revealed that favourable perceptions coexisted with important uncertainties regarding therapeutic scope, and that knowledge was only modestly associated with preference. The findings should not be generalised to all Sri Lankan adults.