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Articles

Health maintenance, meaning, and disrupted illness trajectories in people with low back pain: a qualitative study

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Pages 1-14 | Received 02 Nov 2012, Accepted 26 Aug 2014, Published online: 17 Apr 2015
 

Abstract

Whilst ‘biographical disruption’ remains important for explaining how people rebuild biography following the onset of chronic illness, it does not self-evidently explain the problem of managing a fluctuating chronic condition such as non-specific low back pain. Chronic illness rarely leads to long-term improvement; the trajectory is not always linear, and sudden or gradual improvements alongside deterioration are commonly experienced. In the case of low back pain, self-management often involves utilisation of non-pharmaceutical approaches, personal resources for accommodating pain and disability, as well as managing symptoms with clinical treatments to relieve pain. Such a multifaceted approach – not only concerned with the reduction of symptoms – shifts focus beyond the ‘disease’ state and a single point of disruption, drawing attention to the use of ‘health maintenance actions’ to facilitate a proactive response to illness management. We propose this new approach as an alternative way of understanding the experience of patients with fluctuating health conditions such as low back pain.

Additional information

Funding

This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme [Grant Reference Number RP-PG-0707-10131]; a Programme Grant awarded by Arthritis Research UK [Grant Code H0660]; and an NIHR Research Professorship for Nadine Foster [NIHR-RP-011-015].The views expressed are those of the authors and not necessarily those of the NHS.

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