Living with pain: Experiences, hopes and expectations when going through lumbar spinal fusion - A qualitative study

INTRODUCTION: Lumbar spinal fusion (LSF) is a common surgical treatment for chronic low back pain (CLBP), yet evidence of its effectiveness compared with conservative care remains inconclusive. While pain is the primary clinical indication, psychosocial factors, including hopes and expectations, may influence outcomes. However, little is known about how individuals experience life with CLBP before surgery or what they hope to regain after LSF. OBJECTIVE: To explore patients' experiences with CLBP prior to LSF and their hopes and expectations for life after surgery. METHODS: A qualitative, exploratory study using semi-structured preoperative interviews and analysed using Clarke and Braun's thematic analysis. RESULTS: Fourteen patients (11 women, 3 men) scheduled for LSF participated. Three themes captured how participants experience pain as overwhelming, impacting cognition, emotion, and daily functioning, alongside loss of identity and autonomy, leading to social withdrawal and reduced belonging. Despite these challenges, participants expressed strong hopes, often more prominent than concrete expectations, to regain agency, connection, and meaning in work and family life. CONCLUSION: Living with CLBP prior to LSF involves major negative disruptions to identity, agency, and social relationships. Patients' hopes extend beyond pain relief toward reclaiming life, highlighting the need for holistic, patient-centred rehabilitation.