Patients’ Views of Back Pain

This study looked at low back pain patients from a different perspective — asking the patients what they thought and felt about the care given by general practitioners. The researchers conducted the study by interviewing 52 patients in an semi-structured way. Past studies have, “...employed highly structured questionnaires to elicit patient responses to questions which the researchers had identified as important in advance.” The interviews in this study, however, lasted 60-90 minutes, and were focused on patients’ experiences with back pain and their physicians.

Some of the findings were not surprising: 75% reported that their back pain had resulted in modifications in activity level; 33% were pessimistic about improvement; and 31% knew that they should incorporate preventive strategies in their daily lives, but did not.

Some of the results in this study have a direct application to care for these patients.

• 56% of the patients were reluctant to consult a physician for their care. “Reasons for such reluctance included stoicism and fear of wasting the doctor’s time (17 patients), skepticism about the doctor’s ability to help (10) and concern about jeopardizing their employment prospects (two).”
• “Only 20 respondents recalled being given a medical explanation for their low back pain by a health professional, with which they were satisfied.”
• Twenty-two, or 42%, of the patients were satisfied with their medical care.
• “In particular patients appreciated being given an opportunity to discuss their problem with a good listener...Patients also valued thoroughness in relation to diagnosis. The praised general practitioners who took careful histories, carried out detailed examinations and ordered diagnostic investigations, and they appreciated being offered explanations of the rationale behind such investigations.”
• Of the 52 patients, only one had chosen to pursue a complementary therapist as a regular alternative to medical care. 71% had never used an alternative provider, and most of these did not know much about alternative options.

The authors conclude, “Low back pain is a common condition in general practice, and therefore general practitioners need help to be more sensitive and positive in their management. This help could come from patients themselves, from educational materials, and from paramedical and complementary therapists.”

Skelton AM, Murphy EA, Murphy RJL, O’Dowd TC. Patients’ views of low back pain and its management in general practice. British Journal of General Practice 1996; 46:153-156.

 

 

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