title: Illness action rediscovered: a case study of upper limb pain.
abstract: Theoretical frameworks provide generalised accounts of illness action although empirical studies of the process are still in short supply. This study of upper limb pain provided a case study of illness action; as it is a common condition, there is uncertainty about its treatment and management, orthodox and non-orthodox care are seen as legitimate sources of help and it is linked with a range of causes. Face-to-face informal interviews were carried out with 47 informants with upper limb pain and their practitioners (n= 19). The data were analysed in two different ways. The general stages of the illness action process were identified through a descriptive analysis of the upper limb pain sufferers' accounts and the policies and practices reported by their practitioners. Then, case studies were constructed to depict individual pathways through healthcare and consequences for sufferers. The illness action process was characterised by the normalisation and accommodation of pain informed by a discourse that predominantly invoked ageing and the wear and tear of the body. Practitioners also preferred to adopt a biomechanical approach and were reluctant to attribute psychosocial labels. The case studies illustrated the divergent, negotiated and opportunistic nature of the process and showed that the use of both orthodox and non-orthodox care formed only part of strategies used to manage upper limb pain. Sufferers evaluated the care they received in terms of pain alleviation, and were resigned to searching for the best way of living with their pain.
authors.affiliation: Department of Social Medicine, University of Bristol, Bristol, UK. m.w.calnan@bristol.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Calnan
authors.forename: D
authors.initials: D
authors.lastname: Wainwright
authors.forename: C
authors.initials: C
authors.lastname: O'Neill
authors.forename: A
authors.initials: A
authors.lastname: Winterbottom
authors.forename: C
authors.initials: C
authors.lastname: Watkins
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D000529:Complementary Therapies; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000523:psychology*; D059408:Pain Management; D011369:Professional-Patient Relations; D012651:Self Medication; D012803:Sick Role; D012962:Sociology, Medical; D035501:Uncertainty; D034941:Upper Extremity / Q000503:physiopathology*