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Understanding patients' perceptions of uncomplicated low back pain: a theory-informed qualitative study using the
Shannon M Ruzycki1,2, Yamile Jasaui3, Sameh Mortazhejri4,5
1Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada. Shannon.Ruzycki@ucalgary.ca.
BMC Primary Care
|March 26, 2025
Summary
Most patients with uncomplicated low-back pain (LBP) do not request diagnostic imaging, contrary to common assumptions. Interventions should focus on patient understanding and validation rather than solely on reducing imaging requests.
Area of Science:
- Primary Care
- Health Psychology
- Musculoskeletal Disorders
Background:
- Uncomplicated low-back pain (LBP) is prevalent and challenging, with guidelines discouraging diagnostic imaging due to cost and lack of benefit.
- Despite recommendations, diagnostic imaging for uncomplicated LBP is overused, with patient expectations cited as a contributing factor.
- Understanding patient perspectives on uncomplicated LBP is crucial for developing interventions to curb unnecessary imaging.
Purpose of the Study:
- To explore patient understanding and experiences of uncomplicated low-back pain (LBP).
- To identify patient-related drivers influencing the decision to seek diagnostic imaging for uncomplicated LBP.
- To inform the design of interventions aimed at reducing unnecessary diagnostic imaging in primary care settings.
Main Methods:
- A qualitative study employing semi-structured interviews with individuals experiencing uncomplicated LBP.
- The Common Sense - Self-Regulation Model (CS-SRM) guided interview development and data analysis.
- Framework analysis was used to identify themes related to patient perceptions and behaviors concerning LBP and diagnostic imaging.
Main Results:
- Thirteen participants with a median LBP duration of 5 years participated.
- Most participants viewed uncomplicated LBP as a chronic condition, impacting emotional well-being and life events.
- While most saw a physician and underwent imaging, they generally did not report requesting the tests, often seeking validation and advice instead.
Conclusions:
- Contrary to some assumptions, most patients in this study did not request diagnostic imaging for uncomplicated LBP.
- Patient-facing interventions should incorporate empathy, validation of suffering, and clear explanations of LBP causes and self-management.
- Addressing patients' illness conceptions is key to effectively reducing unnecessary diagnostic imaging.
Keywords:
Diagnostic imagingImplementation scienceLow value carePatient experiencesUncomplicated low back painMore Related Videos
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