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. 1996 Mar;46(404):153–156.

Patients' views of low back pain and its management in general practice.

A M Skelton 1, E A Murphy 1, R J Murphy 1, T C O'Dowd 1
PMCID: PMC1239572  PMID: 8731620

Abstract

BACKGROUND: Low back pain is a common and persistent problem. Research studies seeking to improve the quality of management of this condition have tended to ignore the opinions of patients. There is a growing acceptance of the importance of taking patients' views into account in developing management and educational programmes for a variety of conditions. AIM: This study set out to elicit the views of patients concerning low back pain and its management in general practice. METHOD: Fifty-two in-depth interviews were conducted with patients selected from a broad range of 12 general practices. RESULTS: Analysis of the interviews identified seven themes relating to: quality of life, prognosis, secondary prevention, help-seeking behaviour, explanation of underlying pathology, satisfaction with general practitioner management, and complementary therapy. Different patient viewpoints or perspectives were expressed within each of these themes. Patients adapted to the progress of their low back pain and were not seeking a 'magical cure' from either conventional or complementary therapies. CONCLUSION: Patients' views on low back pain are heterogeneous. The dissatisfaction expressed with medical explanations for the pain may be related to superficial clinical management and the constraints of general practice. Good management of low back pain needs to take patients' complex views of the condition into account.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersson G. B., Svensson H. O., Odén A. The intensity of work recovery in low back pain. Spine (Phila Pa 1976) 1983 Nov-Dec;8(8):880–884. doi: 10.1097/00007632-198311000-00011. [DOI] [PubMed] [Google Scholar]
  2. Borkan J., Reis S., Hermoni D., Biderman A. Talking about the pain: a patient-centered study of low back pain in primary care. Soc Sci Med. 1995 Apr;40(7):977–988. doi: 10.1016/0277-9536(94)00156-n. [DOI] [PubMed] [Google Scholar]
  3. Britten N., Jones R., Murphy E., Stacy R. Qualitative research methods in general practice and primary care. Fam Pract. 1995 Mar;12(1):104–114. doi: 10.1093/fampra/12.1.104. [DOI] [PubMed] [Google Scholar]
  4. Cherkin D. C., MacCornack F. A. Patient evaluations of low back pain care from family physicians and chiropractors. West J Med. 1989 Mar;150(3):351–355. [PMC free article] [PubMed] [Google Scholar]
  5. Cherkin D., Deyo R. A., Berg A. O. Evaluation of a physician education intervention to improve primary care for low-back pain. II. Impact on patients. Spine (Phila Pa 1976) 1991 Oct;16(10):1173–1178. doi: 10.1097/00007632-199110000-00008. [DOI] [PubMed] [Google Scholar]
  6. Deyo R. A., Diehl A. K. Patient satisfaction with medical care for low-back pain. Spine (Phila Pa 1976) 1986 Jan-Feb;11(1):28–30. doi: 10.1097/00007632-198601000-00008. [DOI] [PubMed] [Google Scholar]
  7. Deyo R. A., Diehl A. K., Rosenthal M. How many days of bed rest for acute low back pain? A randomized clinical trial. N Engl J Med. 1986 Oct 23;315(17):1064–1070. doi: 10.1056/NEJM198610233151705. [DOI] [PubMed] [Google Scholar]
  8. Donovan J. L., Blake D. R., Fleming W. G. The patient is not a blank sheet: lay beliefs and their relevance to patient education. Br J Rheumatol. 1989 Feb;28(1):58–61. doi: 10.1093/rheumatology/28.1.58. [DOI] [PubMed] [Google Scholar]
  9. Frank A. Low back pain. BMJ. 1993 Apr 3;306(6882):901–909. doi: 10.1136/bmj.306.6882.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Frymoyer J. W., Cats-Baril W. L. An overview of the incidences and costs of low back pain. Orthop Clin North Am. 1991 Apr;22(2):263–271. [PubMed] [Google Scholar]
  11. Malmivaara A., Häkkinen U., Aro T., Heinrichs M. L., Koskenniemi L., Kuosma E., Lappi S., Paloheimo R., Servo C., Vaaranen V. The treatment of acute low back pain--bed rest, exercises, or ordinary activity? N Engl J Med. 1995 Feb 9;332(6):351–355. doi: 10.1056/NEJM199502093320602. [DOI] [PubMed] [Google Scholar]
  12. Morrell D. C., Wale C. J. Symptoms perceived and recorded by patients. J R Coll Gen Pract. 1976 Jun;26(167):398–403. [PMC free article] [PubMed] [Google Scholar]
  13. Papageorgiou A. C., Rigby A. S. Review of UK data on the rheumatic diseases--7. Low back pain. Br J Rheumatol. 1991 Jun;30(3):208–210. doi: 10.1093/rheumatology/30.3.208. [DOI] [PubMed] [Google Scholar]
  14. Skelton A. M., Murphy E. A., Murphy R. J., O'Dowd T. C. General practitioner perceptions of low back pain patients. Fam Pract. 1995 Mar;12(1):44–48. doi: 10.1093/fampra/12.1.44. [DOI] [PubMed] [Google Scholar]
  15. Skelton A. M., Murphy E. A., Murphy R. J., O'Dowd T. C. Patient education for low back pain in general practice. Patient Educ Couns. 1995 Jul;25(3):329–334. doi: 10.1016/0738-3991(95)00807-c. [DOI] [PubMed] [Google Scholar]
  16. Waddell G. 1987 Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine (Phila Pa 1976) 1987 Sep;12(7):632–644. doi: 10.1097/00007632-198709000-00002. [DOI] [PubMed] [Google Scholar]
  17. Ward T., Knowelden J., Sharrard W. J. Low back pain. J R Coll Gen Pract. 1968 Feb;15(2):128–136. [PMC free article] [PubMed] [Google Scholar]

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