Disruptive Impacts of Living With Chronic Low Back Pain and Experience of Psychologically Informed Physical Therapy – A Qualitative Process Evaluation of a Randomised Control Trial

Abstract

Background: Chronic low back pain (LBP) is a significant and complex health condition affecting one in ten people worldwide. Research has shown that LBP can negatively impact the physical, psychological and social aspects of people’s lives. Clinical practice guidelines recommend a combined physical and psychological management approach (psychologically informed physical therapy) for chronic LBP. A recent multi-site randomised controlled trial (Mind Your Back) aimed to investigate whether combining multimodal physical treatments with an internet-delivered psychosocial intervention (MoodGYM) was more effective for improving disability and self-efficacy in people with chronic LBP, compared to standard treatment. The aim of this study was to conduct a process evaluation to explore the participants’ experiences of living with chronic LBP and their response to interventions provided in the Mind Your Back Trial.Methods: Twenty-five participants volunteered to take part in a semi-structured telephone interview about their experiences of taking part in the Mind Your Back trial and to understand their perspectives of living with chronic back pain. Interviews were transcribed verbatim and data analysed thematically. Results: Three main themes were identified: (1) Ongoing back pain disrupts all aspects of life, (2) Personalised support and therapeutic alliance are important, and (3) MoodGYM lacked relevant, personalised and tailored support. Conclusion: Living with chronic LBP has significant disruptive impacts on everyday life. It is crucial to deliver tailored support and management strategies that are grounded in the everyday lived experiences of people with chronic LBP.