Biguet G.1, Levy Berg A.1, Bullington J.2, Nilsson-Wikmar L.1
1Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden, 2Ersta Sköndal University College, Health Care Sciences, Stockholm, Sweden
Background: The complexity and the high prevalence of long-term non-specific musculoskeletal pain within western society suggest that multiple approaches are required to encourage pain management in primary health care as well as rehabilitation practice. Nowadays, body awareness therapy is commonly incorporated in multi-disciplinary pain rehabilitation. Several studies have pointed out that patients with long-term pain have difficulties in relating to their aching body, and experience the body as alien, intrusive and not manageable. Thus, it seems important to deepen our knowledge of how body awareness can be experienced, further emphasizing which aspects of body awareness are especially important or difficult to achieve for individuals with long-term pain.
Purpose: The aim of the study was to explore how individuals with long-term pain experience the meaning of body awareness.
Methods: In-depth interviews and a phenomenological research approach were deemed appropriate because of its potential to capture the embodied, existential aspects in human lives and to explicate the meaning through descriptions of lived experiences.
Ten participants with long-term musculoskeletal pain, 8 women and 2 men, across a range of ages (25-58 years) and duration of pain (2,5-35 years), were strategically selected from different care settings in Sweden; three physiotherapy clinics in primary care, one pain clinic at a hospital and one out-patient multidisciplinary rehabilitation clinic. Physiotherapists or team coordinators recruited participants in close collaboration with the research team in order to guarantee a wide range in age, sex, social background, pain disorder, and experiences in some kind of body awareness/body-mind therapy. The logic and value of such purposeful sampling was to obtain diversity and richness in experiences.
Results: The analysis revealed that pain puts live on hold, but that body awareness provides a means to regain access to life. Three essential aspects of body awareness in patients with long-term pain could be described. These aspects are part of an evolving and ongoing process which begins with directing focus towards the body, then moves onto the experience of self, and finally on the outside world. The aspects were: (I) Directing attention towards the body with a new intention; (II) Exploring and experimenting broadening the perspective; and (III) Redirecting attention towards the world by trusting the body.
Conclusion(s): Body-awareness can be a means for individuals with long-term pain to regain access to life. However, it is a conscious, arduous and time consuming task that can be experienced as difficult, and requires courage and support from others.
Implications: Knowledge about the way body-awareness could be experienced and achieved by patients with long-term pain can be helpful for physiotherapists in pain rehabilitation clinics and in primary care as it may contribute to the physiotherapists ability to guide the patient in body awareness training. Further, the results of the present study nuanced our knowledge of how body awareness works and can contribute to process of change and positive rehabilitation outcomes.
Funding acknowledgements: The study received no specific grant from any funding agency.
Topic: Pain & pain management
Ethics approval: Approved by the local research ethics committee, Stockholm (2010/618-31/5).
All authors, affiliations and abstracts have been published as submitted.
