A phenomenological approach to understanding the psychological response to chronic low back pain
Abstract
Chronic low back pain (CLBP) is a complex health problem of psychological
manifestations not fully understood. Using interpretive phenomenological analysis, 11
semi-structured interviews were conducted to help understand the meaning of the lived
experience of CLBP; focusing on the psychological response to pain and the role of
depression, catastrophizing, fear-avoidance behavior, anxiety and somatization.
Participants characterized CLBP as persistent tolerable low back pain (TLBP) interrupted
by periods of intolerable low back pain (ILBP). ILBP contributed to recurring bouts of
helplessness, depression, frustration with the medical system and increased fear based on
the perceived consequences of anticipated recurrences, all of which were mediated by the
uncertainty of such pain. During times of TLBP all participants pursued a permanent pain
consciousness as they felt susceptible to experience a recurrence. As CLBP progressed,
participants felt they were living with a weakness, became isolated from those without
CLBP and integrated pain into their self-concept.