From exercise and education to movement and interaction. Treatment groups in primary care for women with chronic muscular pain

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Objective - To develop a group-based treatment programme in primary health care for women with chronic muscle pain, and adjust programme development according to experiences obtained by the participating women and health personnel. The aim of the programme was to help the women develop a tool for handling their chronic state of pain. The article describes and discusses experiences essential for elaboration of the treatment programme. Design - Action research design. Setting - Existing therapy groups in Stovner for women with chronic muscle pain. Subjects - We arranged eight treatment groups, each lasting 12 weeks, and three groups lasting 10 months, with a total of 133 participants. Main outcome measures - Experiences were systematised by means of pragmatic analysis of qualitative data from field notes, tape recordings of focus group interviews, and video recordings of training and discussion groups. Results - While initially the training programme aimed at increasing physical fitness and muscle strength, it gradually developed into activity based on movement with an emphasis on noticing and experiencing. The instruction programme initially aimed at providing information, and developed towards discussion groups with emphasis on mutual understanding and recognition. Conclusions - The training programme is now concentrated on a few, simple exercises and is characterised by awareness of the relationship between breathing and muscle tension. Groups were found to be the main pillar of the programme, characterised by security and a feeling of belonging with room for reflection and development.