title: The early stages of low back pain: a pilot study of patient diaries as a source of data.
abstract: BACKGROUND
  Low back pain accounts for a significant proportion of a GP's workload, but care of the condition is widely regarded as unsatisfactory. Recent recommendations to improve primary care management include more appropriate explanatory models and early access to physical therapy.
  
  
  OBJECTIVE
  This study explored the feasibility and utility of patient diaries as a source of qualitative data on patients' experience of low back pain presenting in primary care.
  
  
  METHODS
  Within a larger study of physiotherapist-led management of low back pain presenting in general practice, a random sample of patients was invited to keep a record of their illness experience over 7 days using a diary. Patients' written accounts were then subject to qualitative thematic analysis.
  
  
  RESULTS
  Diary respondents did not differ from the wider group of patients presenting with back pain. Patients recounted diverse experience of disability, pain and emotional reactions. The specific themes which emerged from our analysis support the relevance to patients of a biopsychosocial paradigm in the management of low back pain.
  
  
  CONCLUSIONS
  Diaries are a feasible and valid source of qualitative data in patients with new episodes of low back pain. In addition, they may provide the clinician with useful information and their completion may offer direct benefits to patients.
authors.affiliation: Chester and Halton Community NHS Trust, Chester, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Miller
authors.forename: M A
authors.initials: MA
authors.lastname: Pinnington
authors.forename: I M
authors.initials: IM
authors.lastname: Stanley
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection / Q000379:methods*; D004739:England; D005194:Family Practice / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D017116:Low Back Pain / Q000209:etiology*; D008499:Medical Records / Q000706:statistics & numerical data*; D008875:Middle Aged; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods*; D012017:Referral and Consultation; D012307:Risk Factors; D013997:Time Factors