Recurrent low back pain: Relapse from a patient perspective

Objective: To explore and describe how patients with recurrent low back pain perceive and respond to the recurrence of pain. Design: A semi-structured interview study. Subjects: Seventeen patients (10 women and 7 men) with recurrent low back pain. Methods: Semi-structured interviews were analysed using the phenomenographic method. Results: Patients' perceptions of relapse of low back pain could be divided into 4 different categories: (i) an unsolved mystery, a source of uncertainty and self-accusation; (ii) an obvious part of life that has to be ignored; (iii) a reminder to keep within limits, both physically and psychologically; and (iv) an indication to change behaviour to prevent further relapse. The categories could be grouped hierarchically such that they reflect to what extent the patients showed readiness and self-efficacy in adopting self-management strategies to prevent further relapses. Conclusion: The results suggest that patients with relapse in low back pain could respond in different ways to the recurrence of pain and show different degree of readiness to change behavioural and movement patterns in order to prevent further relapses. The different responses might be important aspects to which physicians and allied health professionals should pay attention in the rehabilitation process.