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SAT0403 Patients with Chronic Low Back Pain Develop Over Time Positive Coping Strategies Include Striving for Normality, Dealing with Pain, Having High Levels of Physical Activity and Maintaining Social Connections: A Qualitative Study.
  1. F. Bailly1,2,
  2. V. Foltz1,2,
  3. S. Rozenberg1,2,
  4. B. Fautrel1,2,
  5. L. Gossec1,2
  1. 1Paris 6 – Pierre et Marie Curie University
  2. 2Rheumatology, Pitié-Salpétrière Hospital, Paris, France


Background Low back pain (LBP) is a frequent and costly syndrome which has an important impact on quality of life. There is a lack of knowledge in LBP on the patient’s perspective from the broad bio-psychosocial approach.

Objectives To gain further insight into patients’ perspective on coping strategies in LBP.

Methods The qualitative study involved participants with sub-acute or chronic LBP, who took part in four focus group discussions. Interviews were taped and transcribed verbatim, and all phrases were categorized and coded using thematic content analysis.

Results The sample consisted of 25 patients, 11 men and 14 women; ages ranged 25-81 years and disease duration ranged 1-35 years. The interviews lead to the individualization of 5 major coping profiles. (a) The first coping profile was seen as negative: going over the limit and doing ‘too much’ related to negating the disease; ignoring symptoms and being over-active. (b) and (c) The 2 equilibrium statuses (endeavoring to lead a normal life; dealing positively with symptoms but reducing activities) included trying to be normal and minimizing the symptoms (including developing alternative ways of functioning), having social activities, and reinforcing physical activities to forget / lower pain. (d) and (e) The last 2 profiles were related to inhibition: being inhibited by anxiety, fear of the future and frustration; very reduced activities due to negative affects/depression. The only positive aspect of psychological impact was perceived better/more mature perspective on life. The coping profiles were evidenced in 4 major domains of life that patients had to cope with: pain, physical activities both at work and at home, psychological impact/emotions and social interactions. Due to apparent physical normality but reduced activities, patients described feeling perceived as “lazy” (perceived social discrimination). The patient verbatim indicated changes over disease duration with patients initially having negative affects and anxiety, then developing positive coping strategies.

Conclusions This qualitative study gives insights into the patient’s perspective in LBP and brings to light several previously ignored aspects in particular fear of the future, perceived social discrimination and burden of others’ outlook on the disease, and coping strategies such as minimising symptoms to pursue a normal life including sports and leisure activities.

Disclosure of Interest None Declared

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