A longitudinal study of patients' experiences of chronic low back pain using interpretative phenomenological analysis: changes and consistencies.

This paper present data from the second and third rounds of a three-phase longitudinal research project exploring the 'lived experiences' of patients with chronic low-back pain (CLBP) in the United Kingdom. Qualitative, semi-structured interviews were conducted with eight participants 1 and 2 years after the first interviews and after attendance at a medically staffed chronic pain clinic. The transcribed accounts were analysed using interpretative phenomenological analysis and results compared with the data from time one. A main challenge for participants was managing constant unchanging pain experiences and loss across all areas of their lives. Some participants held consistent biomedical understandings of CLBP, continued to focus on the physicality of their pain and adopt a narrow range of behavioural-focused coping strategies and maintained a strong loss orientation. It is proposed that these elements demonstrated embodied experiences and contributed to comprehensive enmeshment of self and pain with little re-establishment of any behavioural activity. In comparison, participants who had experienced pain relief due to physical treatments showed increased use of mind-body strategies, a future orientation and were considered to be less enmeshed in their experiences. These changes were discussed in relation to the relationship between pain remission and illness beliefs.