A narrative approach for the management of low back pain in general practice: An in-depth patient interviews study

The broad range of definitions of low back pain (LBP) and the many associated risk factors on which management strategies are based do not seem to be relevant for general practitioners.

Given the challenges of treating LBP and its impact on individuals' life, we aimed to explore the lived experiences of LBP patients to better understand their feelings, needs, and the internal and external resources they use for coping and treatment.

We used a comprehensive, qualitative, biographical approach to understand the patient's life events and the origins of these events in social life. First, each patient's life story was analysed individually to understand how they constructed their experiences. Then, a joint analysis identified common themes and overlapping patterns across different patient trajectories.

We identified two main action profiles. The first ('risk-taking') reflected a desire for personal independence, where patients struggled to change their habits despite experiencing pain. In the second profile ('quest for meaning'), painful experiences led patients to reflect on their lifestyle and self-functioning, prompting adjustments in their daily habits.

A comprehensive approach to understanding the patients' behaviour in relation to their LBP can improve care strategies. General practitioners should consider not only the physical symptoms but also the patient's social and personal context, including relationships, living environment, work activity, limitations, and guiding values.