Workers’ perspectives on low back pain recurrence: “It comes and goes and comes and goes, but it's always there”

Abstract

Although various measures of low back pain (LBP) recurrence have been proposed, none have been tested to determine if they are consistent with what those with LBP perceive a "recurrence" to be. To further the understanding of LBP recurrence and how to measure it, we examined how individuals with a history of LBP describe their back pain experiences. A qualitative approach was chosen and six mixed-gender focus groups were conducted. Discussions were facilitated by two researchers and structured around predetermined questions. All four authors were involved in the data analysis and thematic congruence was achieved through an iterative process of coding and discussion. Participants included 31 individuals (14 female, 17 male), with ages ranging from early 20s to mid 70s. When asked about LBP recurrence, participants had difficulty understanding the concept. There was a sense that, although the pain may disappear, the condition was always there. Three states were defined: "normal," "flared-up," and "attack." "Normal" could include experiencing pain, but generally represented a tolerable state. "Flared-up" was associated with increased pain, the use of strategies to overcome difficulties, and modified participation. "Attack" state was described as severely disabled: "I just have to lay there." Participants described their experiences in a way that is consistent with the idea that LBP is a fluctuating and disabling health condition. Results cast doubt on the validity of currently available measures of LBP recurrence. Focusing on recurrence of pain without consideration of broader contextual factors will result in an incomplete understanding of the meaning of the pain experience.

The impact of chronic low back pain is partly related to loss of social role: A qualitative study

“…The number of focus groups and participants were close to published focus group studies [29]. This study was conducted by rheumatologists, while most studies in this field are conducted by psychologists: in a recent review of qualitative studies on LBP [4], only one [18] of the 33 studies [5][6][7][8][9][10]13,[19][20][21][22][23]32] was conducted by physicians. Thus, some aspects of experiences of LBP could have been under-evaluated.…”

“…As defined by the World Health Organisation, this condition is accepted as a biopsychosocial phenomenon in which anatomical injury interplays with other factors [2]. Beyond pain and disability, psychological and social aspects have a significant impact on living with chronic LBP [3][4][5][6][7][8][9][10][11][12]. Mental aspects of chronic LBP are related to psychological distress, in particular anxiety and depression [3][4][5][6][7].…”

“…Mental aspects of chronic LBP are related to psychological distress, in particular anxiety and depression [3][4][5][6][7]. Patients develop different active or passive, positive or negative, coping strategies to deal with the pain and functional limitations [8,9,[11][12][13]. Relationships with others may also play an important role in LBP [4,14].…”

Experiences of chronic low back pain: a meta-ethnography of qualitative research

“…The study conducted by Young, Wasiak, Phillips, and Gross (2011) was distinctive in that most participants were still working. For them, periods of relative normality were interrupted by periodic flare-ups and sudden attacks ('I bent over to pick up the walker, then whamo… I didn't think I was going to walk again after that experience', p. 207).…”

Exploring self-management of chronic low back pain in Saudi Arabia

“…Studies have shown that patients who accepted this reality were better able to cope with the condition (Strong and Large1995;Wade 2003). However, patients have adopted various methods for managing LBP, such as avoiding certain postures, not participating in certain activities, prioritising activities and faith (Bowman 1994;Strong and Large1995;Skelton et al 1996;Ong et al 2004;Busch 2005;Young et al 2011). Coping with CLBP Stigma Changing outlook Based on data from ; Froud et al (2014) Several factors influence patients' ability to cope with CLBP, including culture and beliefs (Wade 2003;.…”