Abstract
Background
Almost 80% of people experience low back pain at least once in their life. A quarter suffers from Nonspecific Chronic Low Back Pain (NS-CLBP), where symptoms cannot be justified radiologically. There is evidence that imaging negatively impacts outcomes (increased painkillers and doctors' visits) in NS-CLBP patients. Despite clinical guidelines recommending against the use of imaging, healthcare practitioners and patients still request imaging to explain symptoms.
Method
Qualitative, semi-structured interviews with NS-CLBP patients, physiotherapists, and doctors conducted using purposeful sampling of 6–11 people from each group. The interviews were recorded, transcribed and analysed using framework analysis. Validity was ensured by data triangulation with participants.
Results
Interviews with 11 patients who had an MRI scan, 6 physiotherapists and 6 spine surgeons. Four main themes emerged from synthesis of findings across these three groups.
Discussion
This study provides an insight of the lived experience of NS-CLBP among three different groups. It highlights the difference in expectation between healthcare provider and patients about how CLBP should be managed and the lack of coordination between primary and secondary healthcare services. Although patients seek imaging to explain NS-CLBP, they react to the results negatively. In accordance with fear avoidance model, participants reported fear avoidance behaviours and anxiety following MRI. That affect daily life activities and participation.
Conclusion
This study highlights the need for early management of NS-CLBP patients in primary care. The psychosocial consequences of diagnosing by MRI are fear avoidance and anxiety. The current biomedical education to those patients may promotes these consequences.
Conflict of interest
No conflicts of interest
Study fund
This research was supported through a PhD scholarship from Prince Sattam bin Abdul-Aziz University, Saudi Arabia, at the University of Nottingham, United Kingdom
