Living with chronic low back pain: a metasynthesis of qualitative research

ObjectivesThe purpose of this Qualitative Metasynthesis (QMS) is to articulate the knowledge gained from a review of qualitative studies of patients’ experiences of Chronic Low Back Pain (CLBP).MethodsMeta-ethnographic methodology guided the review of thirty-three articles representing twenty eight studies published in English in peer-reviewed journals between 2000 –2012. A systematic comparison of the main themes from each study was conducted and “synthesised” to create super-ordinate themes. ResultsThree overarching interrelated themes were identified: The impact of CLBP on self; Relationships with significant others that incorporated two streams: Health Professionals and the organisation of Care and relationships with family and friends; Coping with CLBP. Coping strategies were predominantly physical therapies, medication, and avoidance behaviours with very few successful strategies reported. Professional and family support, self-efficacy, motivation, work conditions and exercise opportunities influenced pain experiences. Recommendations included psychological therapies, education, the facilitation of self-management strategies and support groups.DiscussionThe review substantiates CLBP as complex, dynamic and multidimensional, underpinned by experiences of persistent distressing pain, loss, and lowered self-worth, depression, feelings of premature aging, fear of the future. Future research should address the paucity of longitudinal studies, CLBP within a paradigm of loss and issues of ethnicity, gender, ageing