Exploring Why People with Back Pain Use the Pain Management Strategies They Do: Is Research Looking in the Wrong Places?

OBJECTIVE: Low back pain (LBP) is a significant issue with considerable impact on people's lives and economies. A plethora of research has investigated interventions to manage LBP. However, despite considerable knowledge translation efforts, individuals with the condition frequently use management strategies considered to be "ineffective." To address this concern, our aim was to explore why people with LBP choose the management strategies they do. METHODS: We used a predominantly inductive, descriptive qualitative design. We interviewed 20 Australian adults who have or have had LBP to investigate the management strategies they have used and why. Data were analyzed thematically. RESULTS: Analysis identified three interrelated themes that highlight that participants chose management strategies, at least in part, because they: 1) reduce symptoms in the very short term (e.g., immediately, a few hours); 2) have effects beyond the condition (e.g., low cost, lack of negative side effects, convenience, social effects); and 3) are pleasurable. DISCUSSION: These outcomes suggest that people with LBP are likely to have nuanced reasons for choosing the management strategies they use, and this can contrast with the outcomes tested in empirical studies. Our findings suggest that researchers may need to broaden or rethink which outcomes they measure and how, including by meaningfully engaging consumers in research design. Furthermore, clinicians could better explore their patients' reasons for using the strategies they do before suggesting they discard existing strategies or offering new ones.