BELIEFS OF WOMEN WITH CHRONIC LOW BACK PAIN IN RELATION TO THEIR PAINFUL EXPERIENCE

G. Horment-Lara¹, C. Espinoza-Ordóñez², C. Lüttges Sciaccaluga³, V. Aliaga Castillo¹

Background: Chronic pain, with chronic lumbar pain being the most common one, is a problem of high prevalence throughout the world, which implies a great expense for each country. Its association with maladaptive beliefs, psychosocial and cultural factors, which give unique meaning to the painful experience, is currently known.

Purpose: Given the above, and in addition to the lack of information on this matter in Chile and Latin America, it is relevant to know the beliefs that women with chronic low back pain have in relation to their painful experience, based on the nature and duration of pain; fears in relation to pain; family, work and social limitations; self-efficacy perception and recovery expectations.

Methods: A qualitative descriptive and transversal study was developed, using a phenomenological approach. A purposeful sampling included 10 women, ages ranged between 43 and 76 years , with chronic low back pain who are treated at the North Metropolitan Health Service, located in the Metropolitan Region of Chile. Data collection was carried out through individual semi-structured interviews. The data were analyzed using interpretative phenomenological analysis (IPA), and as a strategy to ensure the quality of the research, triangulation of researchers was performed. This study was approved by the ethics committee from the North Metropolitan Health Service, in Santiago, Chile.

Results: An exhaustive description of beliefs regarding pain from women with chronic low back pain for each of the categories was obtained, finding that the main belief concerning the nature of the pain was that it was originated from excessive forces with poor execution.  Regarding the duration of pain, the main belief was that after the spine is damaged, it never recovers completely, being impossible to return to its previous condition. The main fear was that the evolution of their condition would lead to greater disability, requiring the use of a wheelchair to move around. In relation to family limitations, they affirmed that after sexual activity they experienced intense pain, so they avoid sexual intercourse with their partner. The main labor limitation was  low productivity due to pain. With regard to social limitations, they indicated that they have negative feelings and that they isolate themselves to avoid suffering pain in front of others. As for self-efficacy, they turn to their personal and family history to take examples of positive coping. Finally, their recovery expectations were low, they believe that aging will inevitably worsen their spine condition.

Conclusion(s): There are beliefs related to chronic low back pain that could influence the recovery of affected women. The most notable are related to the nature of pain, which installs the idea that spinal injuries are incurable and, therefore, there is no effective treatment; and the catastrophic belief that low back pain will eventually lead to the use of a wheelchair.

Implications: It is important that health team professionals inquire into beliefs regarding painful experience, and take them into consideration in planning their interventions.

Funding, acknowledgements: Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.

Keywords: Chronic low back pain, Beliefs

Topic: Pain & pain management

Did this work require ethics approval? Yes

Institution: North Metropolitan Health Service, Santiago, Chile

Committee: Ethics Committee of the North Metropolitan Health Service, Santiago, Chile

Ethics number: 032/2019