Experiences of living with chronic back pain: the physical disabilities.
OBJECTIVE
Back-related functional limitations are largely assessed using lists of activities, each scored on a yes/no basis and the scores then summed. This provides little information about how chronic back pain (CBP) patients live with their condition. This study describes the consequences of living day-to-day with CBP and documents the 'insider' accounts of its impact on daily life.


METHODS
Unstructured interviews, using the 'Framework' approach with topic guide, were recorded and transcribed verbatim. Subjects were sampled for age, sex, ethnicity and occupation from new referrals with back pain to a rheumatology outpatient clinic. Eleven subjects (5 male, 6 female) were interviewed either in English (n = 9) or their preferred language (n = 2). Interviews were read in-depth twice to identify the topics. Data were extracted in phrases and sentences using thematic content analysis.


RESULTS
Four themes emerged: sleep/rest, mobility, independence and leisure. All subjects reported issues about sleep and rest, nine about mobility, seven about independence and six on leisure. Most descriptions concerned loss and limitation in daily life. Strategies for coping with sleep disruption and physical limitations were described.


CONCLUSIONS
Subjects provided graphic 'in-depth' descriptions of experiences living with CBP every day; expressed regret at the loss of capabilities and distress at the functional consequences of those losses. Facilitating 'adjustment' to 'loss' may be more helpful than inferring the potential for a life free of pain as a result of therapeutic endeavours.
De Souza
Lorraine H
LH
Centre for Research in Rehabilitation, Brunel University, Middlesex, UK. lorraine.desouza@brunel.ac.uk
Frank
Andrew O
AO
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000503:physiopathology* / Q000523:psychology*; D002908:Chronic Disease; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012146:Rest; D012893:Sleep Wake Disorders / Q000503:physiopathology