Abstract
BackgroundLow back pain (LBP) is the second highest cause of health burden in China. Delayed recovery, poor clinical outcomes and persistence of LBP are associated with negative pain beliefs about LBP. Chinese philosophies are nested into the daily life of people in China, which is likely to influence pain beliefs. However, there is lack of knowledge about people’s discourses regarding their LBP in China. The primary aim of this study was to explore the discourses underlying the beliefs of people in China about what causes their persistent or recurrent LBP. The secondary aim was to investigate the sources of these pain beliefs.MethodsPeople (n = 152) from South Central, East and North Mainland China with LBP completed an online survey about what they believed caused their persistent or recurrent LBP and where these understandings came from. Potential causes of persistent or recurrent LBP were explored qualitatively using discourse analysis. The sources of these discourses were assessed by descriptive statistics with conventional content analysis.ResultsFive discourses were identified to underpin participants’ beliefs about what caused their persistent or recurrent LBP, namely: (1) biomedical problems (66.4%), (2) unbalanced lifestyle (48.7%), (3) menstruation and ‘kidney’ status (9.2%), (4) the ‘Five Elements’ imbalance (7.9%), and (5) energy status (5.9%). Most participants responded that their pain beliefs were based on information derived from healthcare professionals (59.2%), followed by the internet (24.3%) and family (23.0%).ConclusionsPeople from moderately and well-developed parts of Mainland China think predominantly in line with a Western biomedical viewpoint about their LBP. Traditional Chinese medicine related pain beliefs mainly to the concept of ‘balance’ were evident on contemporary Chinese society’s understandings of LBP. These cultural beliefs could be relevant to consider in LBP management and involve healthcare professionals, family and patient in this process.
Highlights
Low back pain (LBP) is the second highest cause of health burden in China
This study identified five key discourses underlying the beliefs of people living in China about what causes their persistent or recurrent LBP
The most predominant discourse was that LBP persisted or recurred due to biomedical problems, followed by the discourses influenced by traditional Chinese medicine related beliefs: unbalanced lifestyle, menstruation and ‘kidney’ status, the ‘Five Elements’ imbalance, and mental energy status
Summary
Low back pain (LBP) is the second highest cause of health burden in China. Poor clinical outcomes and persistence of LBP are associated with negative pain beliefs about LBP. The primary aim of this study was to explore the discourses underlying the beliefs of people in China about what causes their persistent or recurrent LBP. In China, a country with a population of 1.4 billion people [3], LBP was estimated to impact 67.3 million people in 2016 with an increase of 19% since 1990 [4], and is ranked as the second highest reason for health burden [4]. The excessive diagnostic imaging for LBP in China adds considerable burden on healthcare in China but is associated with assumptions that diagnostic imaging could identify the causes of LBP [13]
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