Self-management and chronic low back pain: a qualitative study

Title. Self-management and chronic low back pain: a qualitative study. Aims. This paper is a report of a study of the self-management strategies of people with chronic low back pain and how their healthcare professionals perceived their role in facilitating self-management. Background. Chronic low back pain is a complex disorder, challenging to treat, and associated with wide-ranging adverse consequences including physical disability, psychosocial disruption, and increased use of healthcare resources. Most clinical guidelines suggest that self-management strategies are the best treatment option. Design. A qualitative analysis was conducted of semi-structured interviews with 64 people identified as having chronic low back pain and 22 healthcare professionals nominated by that person. The interviews were conducted in 2008. The people with chronic low back pain were asked about their self-management strategies; healthcare professionals were asked about how they perceived their role in the person's self-management. Data were analysed using a content analysis. Findings. The most common strategies used by participants to manage their chronic low back pain were medication, exercise and application of heat. The nominated healthcare professionals were predominantly physiotherapists and general practitioners. Physiotherapists described exercises, particularly those aimed at improving core strength, as the main strategy that they encouraged people to use. General practitioners regarded themselves as primarily having three roles: prescription of pain medication, dispensing of sickness certificates, and referral to specialists. Conclusion. People with chronic low back pain use self-management strategies that they have discovered to provide relief and to prevent exacerbation. The strategies reflect an active process of decision-making that combines personal experience with professional recommendations.