The personal experience of chronic benign low back pain : an interpretative phenomenological analysis.

This thesis is a qualitative study of chronic benign low back pain (CBLBP).
Psychological factors play an important role in the genesis and maintenance of
CBLBP but the processes involved are poorly understood. The meaning of the pain
for the sufferer is considered to be important and more research into this area that
takes an idiographic approach is recommended in the literature. Three empirical
studies are reported which employ Interpretative Phenomenological Analysis (IPA) to
explore the personal experience of CBLBP. A range of themes are discussed that
capture the meaning of the pain for the sufferer and help to understand the dynamic
relationship between the pain sensation, distress and disability. The first study is
exploratory, the participants' struggle to make a coherent sense of their pain is
revealed along with the related personal and social implications. In the second study
the experience of pain itself is focused on more closely in the context of a simple
intervention. Descriptions of the pain are given which reveal its threatening aspect
and suggest that the participants' self-appraisal in the face of this threat is important.
The factors underlying change are discussed and the contribution of contextual factors
is emphasised. The first two studies indicated that the self-concept was worthy of
further study and it became the explicit focus of the third study. The relevance of the
self was highlighted and it was shown to be indivisible from the lived experience of
CBLBP. The three studies reveal the multi-dimensional complexity of CBLBP and
highlight how its inherent `unpleasantnessr'e presentsm ore than a noxious sensory
experience but unfolds within a dynamic personal and social context. The emergent
themes are reviewed and discussed in relation to the literature and implications for
further research and clinical practice are suggested.