Back problems are for life: Perceived vulnerability and its implications for chronic disability

As part of a qualitative research study of the experience of work-related back problems, a series of in-depth ethnographic interviews were conducted with 15 workers receiving treatment for back injuries. Analysis of these data revealed that the workers perceived their back problems as lifelong problems. Many believed that their back injuries had permanently heightened their vulnerability to reinjury and chronic disability. Accommodating this sense of physical vulnerability required a redefinition of one's self and one's future. For some workers, the perceived threat of future back problems was itself disabling and appeared to discourage a return to normal social roles. Workers' interactions with the health care system shaped their perceptions of their bodies and their notions of the appropriate means to cope with their physical vulnerability. Implications of the perception of permanence for the development of chronic disability among workers who experience back problems are examined.