Low Back Pain in People With a Stoma

Abstract

Low back pain (LBP) is a major health problem in western society. Stoma surgery, which involves creating a permanent opening in the abdominal wall, may interfere with the function of the abdominal muscles. Therefore people with a stoma may be at greater risk of developing LBP. A literature review revealed no research exploring a possible link between stoma formation and LBP, nor any study involving patients' perceptions. Therefore, the aims of this study were to determine (1) whether people with a stoma have LBP, (2) whether people with LBP and a stoma perceive that the conditions are linked, and (3) what issues regarding LBP should be included in a large survey of persons with a stoma. Members of the Ileostomy Association of Northern Ireland volunteered to participate in a focus group study. Events from this group were recorded, transcribed, and validated. Thematic analysis was performed. Three themes were identified: (1) the presence of LBP, (2) a perceived link between LBP and a stoma, and (3) relevant issues for LBP. Ten of the 11 participants had experienced at least one episode of LBP, however 5 (50%) emphasized that they did not have a back problem. Six participants had no LBP prior to their surgery, but have experienced episodes of LBP since. The majority thought that the stoma and their LBP experience were linked. Suggested reasons for this link were changes in muscle strength, posture, and activities. Others included having an epidural or a pouching system that did not optimally suit their needs. The results suggest that LBP is a problem for some people with an abdominal stoma and support the need for further study in this population. Two possible areas of future study are an investigation of what the term low back pain means to this population, and further study of the mechanisms that may link stoma surgery to an increased risk of LBP.