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Licensed Unlicensed Requires Authentication Published by De Gruyter April 29, 2019

What decreases low back pain? A qualitative study of patient perspectives

Jenny Setchell ORCID logo, Nathalia Costa, Manuela Ferreira and Paul W. Hodges


Background and aims

This study aimed to determine, from the perspective of individuals living with the condition, what decreases their low back pain (LBP). LBP affects most people at some point during their life. The condition has a meaningful effect on people’s lives including pain, reduced physical and social function, mood fluctuations, and a reduced ability to work. Despite a considerable amount of research on the topic, few strategies to reduce LBP are considered successful, and there has been little investigation into what individuals with the condition believe reduce it. This study aimed to address this gap in the literature by investigating what individuals with the condition believe reduces their LBP.


We employed a descriptive qualitative design using a custom-built online survey. Participants were 130 adults in Australia who self-identified as having current or having had previous LBP with or without co-morbidities. Data from the survey responses were analysed using content analysis to determine which management approaches participants considered to be effective in reducing their LBP.


Participants most commonly said that they believed their LBP was reduced by: heat/cold (86, 66%), medication (84, 64.1%), and rest (78, 60%). Next most common was activity/exercise (73, 55.7%). Other factors such as consulting a health professional (52, 39.7%), stretching/therapeutic exercise (50, 38.1%), resting from aggravating activities (45, 34.3%), and psychological changes (41, 31.3%) were mentioned, but considerably less often.


Current literature points to the inefficacy of many of the factors participants reported as helping to reduce the effects of their condition, including the treatments that were most commonly listed by the participants in this study, namely: heat/cold, medication and rest. A possible cause of this discrepancy might be that individuals with LBP consider temporary relief (on a scale of hours) to be an acceptable outcome, whereas clinical trials tend to consider efficacy by long term outcomes (on a scale of weeks, months or years).


There are several implications of this research. From one perspective, there is the implication that public education about efficacious treatments may need to be enhanced as there is a discrepancy between research findings and the perspectives of individuals living with LBP. On the other hand, these findings also suggest that it is timely to re-examine the focus of LBP research to consider outcomes that are valuable to people living with the condition, which this study implies should include short term or temporary effects. The findings may also help clinicians tailor management to suit the individual patients by increasing the awareness that patient and research perspectives may at times diverge.

Corresponding author: Dr. Jenny Setchell, PhD, The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia, Phone: +61733654506, Fax: +617334687889


We thank the participants who contributed their time and experience to this study.

  1. Authors’ statements

  2. Research funding: The study was funded by grants (Program Grant: #1091302; Centre of Research Excellence grant: #1079078) and fellowships (PH – APP1102905; MLF – APP1143593; JS – APP1157199) from the National Health and Medical Research Council (NHMRC) of Australia.

  3. Conflict of interest: There are no conflicts of interest to declare.

  4. Informed consent: Informed consent was required for participation in this study. Participants gave informed consent before participating in this study.

  5. Ethical approval: Institutional approval was sort and gained for this project. Data was handled within institutional guidelines to ensure anonymity of participants in data storage and reporting. As the research was not a clinical trial it was not registered.


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Received: 2019-01-24
Revised: 2019-03-27
Accepted: 2019-03-28
Published Online: 2019-04-29
Published in Print: 2019-07-26

©2019 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved.