Living with low back pain-Stories of hope and despair.

Previous qualitative research has illustrated a range of issues about the daily life of people living with low back pain (LBP). In this paper, we consider the struggle between hope and despair through consideration of six people's narratives about their experiences of chronic LBP. The six cases were selected from a larger qualitative study of 37 patients in the UK, sampled from a prospective cohort of people consulting their general practitioner. These six cases were selected for particular focus as they exemplify the fluctuating emotions of hope and despair. A number of linked themes emerged which influenced the extent to which people oscillate between hope and despair, the most salient of which were 'uncertainty', 'impact on self', 'social context of living with pain', and 'worry and fear of the future'. It is clear from the narrative accounts that it is not only just physical pain that the back pain sufferer must endure, but also that the psychosocial implications pose an added and often complicated challenge. Health care practitioners should consider these fluctuating emotions of hope and despair in order to facilitate more patient-centred strategies for treatment.

[1]  Simon J Williams,et al.  Transcending the dualisms: towards a sociology of pain , 1995 .

[2]  Simon J Williams,et al.  Chronic illness as biographical disruption or biographical disruption as chronic illness? Reflections on a core concept , 2000 .

[3]  Annika Lillrank.  Back pain and the resolution of diagnostic uncertainty in illness narratives. , 2003, Social science & medicine.

[4]  B. Koes,et al.  Low back pain and sciatica (chronic). , 2003, Clinical evidence.

[5]  Keith Petrie,et al.  The Revised Illness Perception Questionnaire (IPQ-R) , 2002 .

[6]  C. Delmar,et al.  Achieving harmony with oneself: life with a chronic illness. , 2005, Scandinavian journal of caring sciences.

[7]  Carl May,et al.  Medical knowledge and the intractable patient: the case of chronic low back pain. , 1999, Social science & medicine.

[8]  M. Bury.  Chronic illness as biographical disruption. , 1982, Sociology of health & illness.

[9]  J. Maxwell.  Designing a qualitative study. , 1998 .

[10]  A. Breen,et al.  Treatment and the process of care in musculoskeletal conditions. A multidisciplinary perspective and integration. , 2003, The Orthopedic clinics of North America.

[11]  S. Carlsson,et al.  Subjective future as a mediating factor in the relation between pain, pain‐related distress and depression , 1999, European journal of pain.

[12]  I. Holloway,et al.  In the system: the lived experience of chronic back pain from the perspectives of those seeking help from pain clinics , 1999, Pain.

[13]  B. Koes,et al.  Outcome of non-invasive treatment modalities on back pain: an evidence-based review , 2005, European Spine Journal.

[14]  Stephen Morley,et al.  Cognitive-processing bias in chronic pain: a review and integration. , 2001, Psychological bulletin.

[15]  A. Biderman,et al.  Talking about the pain: a patient-centered study of low back pain in primary care. , 1995, Social science & medicine.

[16]  I. Shaw.  How Lay Are Lay Beliefs? , 2002 .

[17]  C. Sällfors,et al.  Oscillating between hope and despair--a qualitative study. , 2002, Child: care, health and development.

[18]  P. Croft,et al.  Establishing Self and Meaning in Low Back Pain Narratives , 2004 .

[19]  A. Silman,et al.  Outcome of low back pain in general practice: a prospective study , 1998, BMJ.

[20]  M. Mishel.  Uncertainty in Chronic Illness , 1999, Annual Review of Nursing Research.

[21]  T. Maguire,et al.  Structuring the meaning of hope in health and illness. , 1999, Social science & medicine.

[22]  H. Eriksen,et al.  European guidelines for prevention in low back pain , 2006 .

[23]  J. Morse,et al.  Linking concepts of enduring, uncertainty, suffering, and hope. , 1999, Image--the journal of nursing scholarship.

[24]  Jonathan A. Smith,et al.  Living with a body separate from the self. The experience of the body in chronic benign low back pain: an interpretative phenomenological analysis. , 2006, Scandinavian journal of caring sciences.

[25]  N. Obuchowski,et al.  Magnetic Resonance Imaging of the lumbar spine in people without back pain , 2017, AL-QADISIYAH MEDICAL JOURNAL.

[26]  C. Chew‐Graham,et al.  Framing the doctor-patient relationship in chronic illness: a comparative study of general practitioners' accounts. , 2004, Sociology of health & illness.

[27]  S. Ekman,et al.  Elderly persons' experiences of living with venous leg ulcer: living in a dialectal relationship between freedom and imprisonment. , 2001, Scandinavian journal of caring sciences.

[28]  E. Severinsson,et al.  Hope during the first months after acute spinal cord injury. , 2004, Journal of advanced nursing.

[29]  J. Morse,et al.  Delineating the concept of hope. , 1995, Image--the journal of nursing scholarship.

[30]  L. Hydén,et al.  Pain Gestures: The Orchestration of Speech and Body Gestures , 2002 .

[31]  Elaine Scarry.  The Body in Pain , 2020, The Body.

[32]  D. Ezzy,et al.  Illness narratives: time, hope and HIV. , 2000, Social science & medicine.

[33]  J. Morse,et al.  Strategies for assessing and fostering hope: the hope assessment guide. , 1997, Oncology nursing forum.

[34]  J. Donovan,et al.  The significance and consequences of having painful and disabled joints in older age: co‐existing accounts of normal and disrupted biographies , 2002 .

[35]  C. Glenton.  Chronic back pain sufferers--striving for the sick role. , 2003, Social science & medicine.

[36]  M. Roland,et al.  The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. , 2000, Spine.

[37]  Jonathan A. Smith,et al.  The personal experience of chronic benign lower back pain: An interpretative phenomenological analysis , 1998 .

[38]  C. Chesla.  Nursing Science and Chronic Illness: Articulating Suffering and Possibility in Family Life , 2005, Journal of family nursing.

[39]  Lex M. Bouter,et al.  Spinal Radiographic Findings and Nonspecific Low Back Pain: A Systematic Review of Observational Studies , 1997, Spine.

[40]  K. Vehviläinen-Julkunen,et al.  Hope in nursing research: a meta-analysis of the ontological and epistemological foundations of research on hope. , 1997, Journal of advanced nursing.

[41]  Jari Kylmä,et al.  Despair and hopelessness in the context of HIV--a meta-synthesis on qualitative research findings. , 2005, Journal of clinical nursing.