Abstract
Background: Chronic back pain is a complex and costly health problem, treated by a wide range of practitioners, with different belief systems and approaches. Despite the range of options available, many patients appear to be dissatisfied with the treatment that they receive. This may be due to a mismatch between patients’ and practitioners’ beliefs about the cause of the pain and their expectations for treatment.
Objectives: To explore patients’ beliefs about the causes of their chronic back pain and their expectations regarding treatment.
Methods: Group interviews were held with two sample groups of individuals (experiencing moderate and severe chronic pain) to inform a series of qualitative individual interviews with patients and practitioners, exploring beliefs about the causation of chronic pain and expectations for treatment.
Participants were identified from respondents reporting chronic pain in a postal questionnaire survey administered through a local general practice. Participants were allocated to groups according to the severity of their pain, as measured by the Chronic Pain Grade. Those with grades II and I were allocated to group one and those with grades III and IV to group two.
Results: Participants presented sophisticated accounts of their pain and their care seeking. General practitioners were seen as the most appropriate first ‘port of call’, as chronic back pain was viewed as a medical problem requiring a medical solution such as X-rays, referral to hospital specialist and eventually operations. Participants presented to their GP in hope of a medical solution, which was seldom realised. Participants appeared to be resolved to this situation, yet sustained the belief that a different way of communicating their problem to their GP may lead to appropriate action.
Conclusion: There was a marked contrast between the groups on some issues, which will be explored further within this presentation.
Correspondence should be addressed to the editorial secretary: Dr Charles Pither, c/o British Orthopaedic Society, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
