Psychosocial consequences of diagnosing nonspecific low-back pain radiologically: a qualitative study

ABSTRACT

Background

Chronic low back pain (CLBP) is a complex biopsychosocial problem with financial implications for society. Most LBP is categorized as nonspecific CLBP (NS-CLBP); magnetic resonance imaging (MRI) is increasingly used in the investigation of LBP but has a high false-positive rate for NS-CLBP.

Purpose

To explore the psychosocial factors associated with diagnosing NS-CLBP by MRI in Saudi Arabia.

Methods

Using a qualitative design, 11 patients with CLBP without a clear medical diagnosis who had received an MRI scan were interviewed using a semi-structured technique, and transcripts were analyzed using framework analysis.

Results

Four themes of relevance to the psychosocial consequences of using MRI to diagnose CLBP were identified: 1) impact on social participation after MRI diagnosis; 2) psychological impact of MRI diagnosis; 3) conflicting advice; and 4) patient education. Although some patients expressed a sense of relief following the identification of an objective explanation of their symptoms by MRI, a number of negative consequences were also identified. In particular, fear-avoidance behavior and anxiety were apparent.

Conclusion

The use of MRI scanning in the diagnosis of LBP may lead to psychosocial factors influencing participation in physical and social daily activities.

KEYWORDS:

• Back pain
• psychosocial factors
• imaging
• qualitative

Acknowledgments

The authors would like to express their gratitude to Saudi Spine Society for partially funding this project.

Disclosure statement

The author(s) declared no potential conflicts of interest.