Background
Methods
Databases searched and inclusion and exclusion criteria
Search strategy
Appraisal of included papers
Data extraction and analysis
Results
Lead author & year | Country | Sample size | % Female | Central age (mean/median) | Aim | Setting |
---|---|---|---|---|---|---|
Allegretti, 2010 [32] | USA | 23 | 48 | 45 | To explore patient and physician interviews and improve communication | Family care centre |
Benjaminsson, 2007 [33] | Sweden | 17 | 59 | 36 | To explore how patients respond to recurrence of pain | Physiotherapy clinic |
Borkan, 1995 [34] | Israel | 66 | 65 | 39.5 | To explore patients’ perceptions and experiences | Family practice, clinic, or home |
Bowman, 1991 [35] | USA | 15 | 40 | ND | To investigate the meaning of chronic LBP | ND |
Bowman, 1994a [36] | USA | 15 | 40 | ND | To describe life with LBP | Pain management centres |
Bowman, 1994b [37] | USA | 15 | 40 | ND | To examine the reaction of individuals to chronic LBP | ND |
Busch, 2005 [38] | Sweden | 22 | 68 | 41 | To examine the development of pain related appraisals, coping and well behaviours, as well as to investigate how these processes affect one another during the course of LBP | Private clinic room |
Campbell, 2007 [39] | UK | 16 | ND | ND | To examine expectations for pain treatment and outcome and to determine whether they are influential in maintaining health service consumption | ND |
Chew, 1997 [40] | UK | 20 | 82 | ND | To explore how sufferers of LBP describe their pain and its impact on their lives | ND |
Cook, 2000 [41] | ND | 7 | 57 | 42.3 | To gain an in-depth understanding of individual patients’ experiences of LBP and active rehabilitation | Home, or physiotherapy clinic |
Coole, 2010 [31] | UK | 25 | 52 | 44.7 | To explore the experiences of employed people with back pain regarding the help they have received from GPs | Home, workplace, or local clinic |
Coole, 2010 [42] | UK | 25 | 52 | 44.7 | To explore the individual experiences and perceptions of patients awaiting rehabilitation who were concerned about their ability to work because of persisting, or recurrent, low back pain | Home, workplace, or local clinic |
Corbett, 2007 [43] | UK | 37 | 59 | ND | To explore the struggle between hope and despair through consideration of six people’s narratives about their experiences of chronic LBP | Home, or research centre |
Crowe, 2010 [44] | New Zealand | 64 | 48 | 55.1 | To investigate experiences of the impact of LBP | ND |
Dean, 2010 [47] | New Zealand | 33 | 18 | 47.7 | To explore and document the experiences of NZ farm workers who continue to work despite their LBP | ‘Place of convenience to the participant’ |
Hooper, 2005 [49] | UK | 5 | 50 | ND | To provide opportunities to reflect on clinical practice and on the role of informal carers within the provision of health care for the back pain patient | ND, although it is clear that a participant with back pain has been interviewed with his wife (also his expert carer) |
Holloway, 2007 [48] | UK | 18 | 50 | 53 | To explore and conceptualise the experiences of people of working age who seek help from pain clinics for LBP | Patients’ homes |
Hush, 2009 [12] | Australia | 36 | 42 | 41 | To explore patients’ perceptions of recovery from LBP | Meeting room at University of Sydney |
Hush, 2010 [13] | Australia | 36 | 42 | 41.6 | To explore whether NRS/RMDQ capture meaningful changes | ND |
Keen, 1999 [27] | UK | 27 | 37 | ND | To explore the association influence changes in physical activity and the way individuals perceive and behave with their LBP and the impact of this on physical activity | Homes of participants, and office of PI |
Layzell, 2001 [50] | UK | 12 | 50 | ND | To explore how back pain affects sufferers’ lives | ND |
Liddle, 2007 [51] | UK | 28 | 78 | ND | To explore experiences, opinion, and treatment expectations of LBP to identify what treatment components are valued | Private room in university |
May, 2000 [52] | UK | 12 | 50 | ND | To explore ways persons with long standing chronic LBP respond to medical doubt about the presence of organic pathology | ND |
Morris, 2004 [53] | UK | 6 | 50 | ND | Patients’ experiences of attending a back rehabilitation programme were examined | Participant choice of home, quiet room in hospital, or clinic |
Ong, 2003 [28] | UK | 6 | 50 | ND | To describe course of LBP over 12 months | ND |
Ong, 2004 [54] | UK | 16 | 38 | ND | To explore how people report LBP to clinicians | Patients’ homes |
Ong, 2006 [29] | UK | 2 | 100 | ND | To explore the role of concordance in therapeutic relationships through directly comparing patients’ and clinicians’ accounts of the diagnosis and impact of LBP | Patients’ homes |
Osborn, 1998 [55] | UK | 9 | 100 | ND | To explore the sufferer’s personal experiences of their pain | ND |
Osborn, 2006 [56] | UK | 6 | 40 | 44 | To explore and articulate the meanings and themes that make up the personal experience of the body when in pain | ND |
Reid, 2004 [57] | UK | 50 | 54 | ND | To explore the perceived health needs of chronic LBP patients | Homes and clinics |
Skelton, 1996 [58] | UK | 52 | 50 | 41 | To elicit the views of patients concerning LBP and its management in general practice | ND |
Slade, 2009 [61] | Australia | 18 | 50 | 51.2 | To determine participant-experience of exercise programmes for non-specific LBP | ND |
Slade, 2009 [59] | Australia | 18 | 50 | 51 | To determine what factors are important for patients to engage in exercise programmes | ND |
Slade, 2009 [60] | Australia | 18 | 50 | 51 | To investigate and summarise participant experience of exercise programmes for non-specific LBP and the effects of these experiences on exercise participation and engagement | ND |
Sloots, 2010 [62] | Netherlands | 23 | 52 | 40 | To explore which factors led to drop-out in patients of Turkish and Moroccan origin with chronic nonspecific LBP who participated in a rehabilitation programme | Participant choice of home or clinic |
Smith, 2007 [63] | UK | 6 | 33 | 44 | To explore how chronic benign low back pain may have a serious debilitating impact on the sufferer’s sense of self | ND |
Snelgrove, 2009 [64] | UK | 10 | 70 | ND | To understand the meaning of LBP for participants with longstanding history of chronic pain | Patients’ homes |
de Souza, 2007 [45] | UK | 11 | 55 | 49.3 | To explore and describe the physical consequences of living day-to-day with LBP and to document insider accounts of how the pain impacts daily activities | Participants’ homes |
de Souza, 2011 [46] | UK | 11 | 55 | 49.3 | To explore interactions and relationships within the family and the workplace from the perspective of the person with chronic spinal pain | Participants’ homes |
Sokunbi, 2010 [65] | UK | 9 | 67 | 46.6 | To explore the experiences of a sample of individuals with chronic LBP who participated in an RCT of exercises | Private room in university |
Strong, 1995 [67] | New Zealand | 19 | 58 | 53.7 | To explore coping strategies | ND |
Strong, 1994 [66] | Australia | 8 | 50 | 54.4 | To explore relevant dimensions of pain | Private room in Brisbane Royal Hospital |
Tarasuk, 1995 [30] | Canada | 15 | 33 | ND | To learn about individuals’ experiences and perspectives of longer term ramifications of LBP | ND |
Tavafian, 2008 [68] | Iran | 24 | 100 | 42.9 | To explore Iranian womens’ beliefs about causation | ND |
Tveito, 2010 [69] | USA | 15 | 33 | ND | To address legitimacy concerns in the workplace, particularly those relating to workers’ perceptions of reactions of employers, supervisors, and co-workers | Quiet office |
Young, 2011 [73] | Canada | 31 | 45 | ND | To determine the meaning participants associated with the term ‘recurrence’ | Public library in Vancouver |
Wade, 2003 [70] | South Africa | 3 | 100 | ND | To provide a description of the life-world of people with chronic low back pain | ND |
Walker, 1999 [71] | UK | 20 | 40 | ND | ND | Participants’ homes |
Walker, 2006 [72] | UK | 20 | 40 | ND | To provide a more detailed understanding of the lived experience of chronic back pain prior to seeking help from pain clinics | Participants’ homes |
First-order themes
Theme 1: activities
Theme; subtheme | Quote number | Quote |
---|---|---|
Activities; domestic | 1 | “As soon as my back goes: that’s it, I don’t mow my lawn for a couple of months.” (Mick,40) [13] |
2 | “Things like [cleaning the] bathroom and shower and stuff, because you have to get right in and you’re bending over when you’re scrubbing.” (Angela, 35) [13] | |
Activities; Leisure, rest, and sleep | 3 | “I would go in the garden and do a bit of this and a bit of that, you know, but now I just don’t bother. … I used to go and play golf… to relax, and things like that.” (Subject 1) [46] |
Relationships | 4 | “The worst thing about this pain is that you are in pain, yet everybody else suffers with you.” (Patient 1) [46] |
Relationships; damage and isolation | 5 | “I’ve given up on holidays because it spoils it for everyone else” (Patient 4) [39] |
6 | “Your wife says “come on, get your act together” and that makes you feel bloody terrible.” (Patient 13) [39] | |
Relationships; family and cohabitation | 7 | “My oldest son, a four year old, says, “What is it Daddy, you used to hold me in your arms, why don’t you now?” (Anon.) [34] |
8 | “My wife even turned on me, thinking it was all put on. She came into the bedroom one morning to find me flat on the floor, unable to move, and she naturally assumed that I was putting it on. From that point on I’ve just lived on my own.” (Colin, 46) [72] | |
Relationships; sex | 9 | “Sex, sex is very important. It’s very important” (Patient 4) [46] |
10 | “I mean you don’t look ill, you’re not flat on your back, so you know, is it an excuse, ‘oh I’ve got a headache’, do you know what I mean?” (Ruth) [55] | |
Relationships; social | 11 | “You go out to a restaurant, halfway through a meal, because you’ve been sat for too long, I have to get up and go for a walk.” (Anon.) [41] |
12 | “…we won’t go anywhere now because of that [being boring with little to talk about except pain]. I get too embarrassed and I just hate being in company and you always get onto that subject [pain]. And if you’re out for a social evening the last thing people want to hear is what your misery, so I just, that’s why we don’t go out often.” (Becky) [55] | |
13 | I don’t go out, I don’t answer the phone, I live at the back of the house and I dread it when the postman comes. … I don’t know what to say, or anything, I just feel embarrassed. You just think ‘what do they think of me?’” (Kevin) [63] | |
Work; anxiety | 14 | “My reading is poor, I can’t spell for jack… it’s like I’m in a no-win situation … All my work comes physical” (Patient 12) [32] |
Work; off-sick | 15 | “I don’t look sick, I don’t limp, I don’t have a cane, I’m not in a wheelchair, I don’t look terrible … I look good. So [the people I work with] could have the perception that she’s not really sick, she’s just taking days off” (Participant 14) [30] |
Work; financial | 16 | “I didn’t know what to do … they [doctors] said ‘there’s nothing there, there’s nothing there whatever’… so I was scared of chiropractor, and of course I couldn’t afford it either, so there was massage therapy - I couldn’t afford that either. Which one is the cheapest? Acupuncture! So I looked through the Yellow Pages and there was one and I said I’ll give him a call.” (Participant FG5) [73] |
17 | “I can’t go off-sick. I can’t afford to go on half-pay [incapacity]. So … so that’s a real dilemma and then I think: God, I have to work until I’m 65! I’ve got a mortgage to pay. How am I going to cope? … You start thinking: what if it never goes, right? What if it gets worse? What am I going to do?” (Anon.) [43] | |
Stigma; deligitimisation | 18 | “I remember at my sickness interview - you can see the disbelief in the manager’s eyes, and I’m thinking OK well …” (male, aged 37) [42] |
Stigma; diagnosis | 19 | “..but you can’t see pain, so they don’t know do they? So they automatically assume that there’s nowt wrong with you” (Alice) [55] |
20 | “I just don’t appreciate them trying to tell me that the pain is in my head. You know, in so many words they tell me the pain is in my head and I have feelings in my back … like I say they feel it’s in my head or I’m fronting my back pain.” (Anon.) [37] | |
21 | “…it always seems sub-consciously that malingering thing, you can’t put your finger what it is, you haven’t got a broken leg or … You have to have stitches to show for it or something…” (Carolyn) [61] | |
22 | “It’s frustrating sometimes when [going to] a doctor -- yes they’ve studied it, but they haven’t lived it” (Participant FG2) [73] | |
Stigma; meeting expectations | 23 | “A very arrogant [doctor] sat me down and said `What the bloody hell do you expect me to do if you are still working?’ And because I was still working, obviously my back wasn’t that bad. But it was.” (Sufferer 1) [28] |
24 | “When I’m good, I’m really good, so you walk around and people say `Why did you retire?’ I’ve had some people sort of either directly or imply `look you’re up and walking around, what’s your problem?” (Alex, 57) [61] | |
Changing outlook; quest for diagnosis | 25 | “I found out since that it’s not been diagnosed correctly. They’ve been giving me the wrong exercises for somebody with what I’ve got now. For 10 years I’ve been doing exercises according to this type of pain, when it’s been aggravating the other thing that was never diagnosed, it was always there but they never looked at it.” (Jean) [61] |
Changing outlook; psycho-emotional | 26 | “I mean, I’ve had days and weeks where I’ve just got depressed over it, and I think, well, I can’t be bothered, there’s no point, it’s not getting better.” (Anon.) [41] |
27 | “Oh aye, aye, I’m down in the dumps most of the time as [wife] knows. If it wasn’t for the missus I’d be bloomin’ terrible I think.” (Will) [64] | |
28 | “I’d love that [being alone on a desert island] … but to be away from people and not to have to be something else you’re not, that would be bliss. … I’d still be a miserable old git but it wouldn’t matter, its only when other people come around that it matters.” (Tony) [63] | |
29 | “Oh yeah, its in two parts, the old good bit, and the pain bit, which has gone wrong. … One bit works, the other doesn’t, like a section has gone wrong, when it’s bad and I can’t move properly, it’s like it’s not part of me, it won’t obey.” (Lynette) [56] | |
30 | “I felt like a wasp with a very tiny waist. Just imagine! Such a waist may snap anytime! It was horrible, I just couldn’t move! I didn’t think I’d make it.” (Anon.) [38] | |
Changing outlook; adaptation and acceptance | 31 | “I would like to take medical retirement … it would be nicer to actually say to people ‘I’m retired’ rather than ‘I’m off sick’ (Reg) [48] |
32 | “After a bad night I can’t settle, but the only way I find if after you’ve taken the pain killers, and the pain is still there, is to actually slide off the chair and kneel facing the chair, taking all the weight on my knees” (Anon.) [64] |