Date of Award

January 2018

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Larry Davidson

Abstract

Objectives: People with chronic back pain encounter considerable psychological and social challenges. Through personal narratives, this project examines the ever-evolving relationship between chronic back pain, sense of self-efficacy, and perceived role in interpersonal relationships, both in the community and within the health care system.

Methods: In-person semi-structured interviews were conducted with 20 adult patients attending a specialized interventional spine pain clinic. The interview transcripts were subjected to inductive thematic analysis, and themes were labeled descriptively. Participant responses were intentionally not analyzed within the context of an existing theoretical framework, so that the content of participant responses would directly drive the emphasis of the findings.

Results: Participants described chronic back pain as a lonely struggle amid diminished capacity to work, enjoy leisure time, and contribute to social relationships. Feelings of needing to handle pain independently contrasted with the reality of having to rely on others for help, and this tension created anxiety. Participants negotiated these emotional complexities in their relationships with treatment providers as well, needing to advocate for themselves in a system that often presented inadequate treatment options, and where providers varied in responsiveness to participants’ psychosocial experience of pain.

Discussion: The lived experience of chronic back pain was characterized by a conflict between the desire for self-efficacy, a sense of isolation, and the paradoxical need to rely on others. Participants found existing biomedically focused treatment modalities to be largely inadequate in reducing pain, improving function, or enhancing their quality of life. Interdisciplinary interventions that allow patients to navigate chronic back pain by seeking help for their diminished capability, while rebuilding and retaining a sense of autonomy and self-worth, are indicated.

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This is an Open Access Thesis.

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