Chasing the ghosts: the impact of diagnostic labelling on self-management and pain-related guilt in chronic low back pain patients.

Abstract

clear diagnosis cannot be established; as a result patientsare given labels such as non-specific low back pain. Thereis some evidence to suggest that lack of a clear diagnosis isassociated with negative psychological, clinical andbehavioural outcomes. The main aim of this study was toexamine CLBP patients’ understanding, feelings andbehaviour in response to their diagnostic labels. Semistructuredinterviews were conducted with twenty CLBPpatients who were recruited from one osteopathic and onepain management clinic in the UK. Sampling, datacollection and analysis were driven by a grounded theoryapproach. Data were analysed through four stages ofcoding: open, selective, axial and theoretical coding. Datacollection and coding continued until data achievedsaturation. Results indicated that lack of a clear diagnosis isassociated with distress, further treatment seeking anduncertainty. It also influenced participants’ perception oftheir social relationships; having visible evidence and aclear diagnosis gave patients’ pain more social credibility.Participants reported feeling guilty about the consequencesof their pain to themselves and others, and for failing torecover. Overall, participants’ narratives suggest that atleast for some, absence of a clear diagnosis hasconsiderable negative implications. The goal of the studywas to inform clinicians and policy makers about theimpact of diagnosis on CLBP patients’ adjustment andemotional burden; findings suggest that legitimising thepain experience is of prime importance to CLBP patients