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. 2014 Feb 21:15:50.
doi: 10.1186/1471-2474-15-50.

A systematic review and meta-synthesis of the impact of low back pain on people's lives

Robert Froud  1 , Sue Patterson, Sandra Eldridge, Clive Seale, Tamar Pincus, Dévan Rajendran, Christian Fossum, Martin Underwood
Affiliations

A systematic review and meta-synthesis of the impact of low back pain on people's lives

Robert Froud et al. BMC Musculoskelet Disord. .

Abstract

Background: Low back pain (LBP) is a common and costly problem that many interpret within a biopsychosocial model. There is renewed concern that core-sets of outcome measures do not capture what is important. To inform debate about the coverage of back pain outcome measure core-sets, and to suggest areas worthy of exploration within healthcare consultations, we have synthesised the qualitative literature on the impact of low back pain on people's lives.

Methods: Two reviewers searched CINAHL, Embase, PsycINFO, PEDro, and Medline, identifying qualitative studies of people's experiences of non-specific LBP. Abstracted data were thematic coded and synthesised using a meta-ethnographic, and a meta-narrative approach.

Results: We included 49 papers describing 42 studies. Patients are concerned with engagement in meaningful activities; but they also want to be believed and have their experiences and identity, as someone 'doing battle' with pain, validated. Patients seek diagnosis, treatment, and cure, but also reassurance of the absence of pathology. Some struggle to meet social expectations and obligations. When these are achieved, the credibility of their pain/disability claims can be jeopardised. Others withdraw, fearful of disapproval, or unable or unwilling to accommodate social demands. Patients generally seek to regain their pre-pain levels of health, and physical and emotional stability. After time, this can be perceived to become unrealistic and some adjust their expectations accordingly.

Conclusions: The social component of the biopsychosocial model is not well represented in current core-sets of outcome measures. Clinicians should appreciate that the broader impact of low back pain includes social factors; this may be crucial to improving patients' experiences of health care. Researchers should consider social factors to help develop a portfolio of more relevant outcome measures.

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Figures

Figure 1
Figure 1
Flow chart showing study identification, and numbers and types of excluded studies, and numbers of included studies.
See this image and copyright information in PMC

References

    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V. et al.Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013;380(9859):2163–2196. - PMC - PubMed
    1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S. et al.Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013;380(9859):2197–2223. - PubMed
    1. Donaldson L. 150 years of the annual report of the Chief Medical Officer. London: Department of Health; 2009.
    1. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84:95–103. - PubMed
    1. Dunn KM, Croft PR. Epidemiology and natural history of low back pain. Eura Medicophys. 2004;40(1):9–13. - PubMed

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