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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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1877-8879
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Volume 19, Issue 3

Issues

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

Jenny SetchellORCID iD: https://orcid.org/0000-0002-9513-9608 / Nathalia Costa
  • The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Manuela Ferreira
  • Institute of Bone and Joint Research/The Kolling Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Paul W. Hodges
  • The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-04-29 | DOI: https://doi.org/10.1515/sjpain-2019-0018

Abstract

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.

Methods

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.

Results

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.

Conclusions

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).

Implications

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.

Keywords: patient perspectives; qualitative research; self-management; quality of life; lumbar spine

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About the article

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


Received: 2019-01-24

Revised: 2019-03-27

Accepted: 2019-03-28

Published Online: 2019-04-29

Published in Print: 2019-07-26


Authors’ statements

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.

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

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

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.


Citation Information: Scandinavian Journal of Pain, Volume 19, Issue 3, Pages 597–603, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1515/sjpain-2019-0018.

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

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