The personal experience of chronic benign lower back pain: An interpretative phenomenological analysis

This thesis is a qualitative study of chronic benign low back pain (CBLBP). Psychological factors play an important role in the genesis and maintenance of CBLBP but the processes involved are poorly understood. The meaning of the pain for the sufferer is considered to be important and more research into this area that takes an idiographic approach is recommended in the literature. Three empirical studies are reported which employ Interpretative Phenomenological Analysis (IPA) to explore the personal experience of CBLBP. A range of themes are discussed that capture the meaning of the pain for the sufferer and help to understand the dynamic relationship between the pain sensation, distress and disability. The first study is exploratory, the participants' struggle to make a coherent sense of their pain is revealed along with the related personal and social implications. In the second study the experience of pain itself is focused on more closely in the context of a simple intervention. Descriptions of the pain are given which reveal its threatening aspect and suggest that the participants' self-appraisal in the face of this threat is important. The factors underlying change are discussed and the contribution of contextual factors is emphasised. The first two studies indicated that the self-concept was worthy of further study and it became the explicit focus of the third study. The relevance of the self was highlighted and it was shown to be indivisible from the lived experience of CBLBP. The three studies reveal the multi-dimensional complexity of CBLBP and highlight how its inherent `unpleasantnessr'e presentsm ore than a noxious sensory experience but unfolds within a dynamic personal and social context. The emergent themes are reviewed and discussed in relation to the literature and implications for further research and clinical practice are suggested.