Living a Life Full of Pain: Older Pain Clinic Patients’ Experience of Living With Chronic Low Back Pain

2018 ◽  
Vol 28 (9) ◽  
pp. 1434-1448 ◽  
Author(s):  
Meredith Stensland ◽  
Sara Sanders
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Later Life ◽  
Pain Clinic ◽  
Main Theme ◽  
Low Back ◽  
Patient Centeredness ◽  
Study Objective

Chronic low back pain (CLBP) is older adults’ most common pain complaint and is associated with many physical and psychosocial consequences, which have been quantitatively examined. However, little research has qualitatively examined the experience itself of CLBP in later life. Study objective was to understand older adults’ lived CLBP experience. Guided by van Manen’s phenomenological method, 21 pain clinic patients aged 66 to 83 completed semistructured interviews. Under the main theme “living a life full of pain,” results are reflected in four existential subthemes: (a) Corporeality: The pain is relentless and constantly monitored, (b) Temporality: To live with pain is to live by pacing day and night, (c) Relationality: Pain creates limits that can be tested or obeyed, and (d) Spatiality: Manipulating the space around me to accommodate the pain. Findings improve understanding of the patient experience of late life CLBP and highlights the importance of empathy and patient-centeredness when treating older adults.

“If You Don’t Keep Going, You’re Gonna Die”: Helplessness and Perseverance Among Older Adults Living With Chronic Low Back Pain

2020 ◽  
Author(s):  
Meredith Stensland
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Lived Experience ◽  
Chronic Low Back Pain ◽  
Adult Population ◽  
Pain Clinic ◽  
Low Back ◽  
Illness Experiences ◽  
Design And Methods

Abstract Background and Objectives Chronic low back pain (CLBP) is the leading cause of disability worldwide and the most common pain complaint among the rapidly growing older adult population. As part of a larger qualitative study examining the lived experience of CLBP among older adults, the objective of the present study is to understand how older pain clinic patients experience helplessness and also how they foster perseverance amid treatment-resistant CLBP. Research Design and Methods Using van Manen’s phenomenological method, semistructured, in-depth, one-on-one interviews were conducted with 21 older pain clinic patients (aged 66–83) living with CLBP. Data were iteratively analyzed via line-by-line thematic coding. Results Findings dually illustrate how participants were living a battle between helplessness and perseverance; the final thematic structure revealed 5 subthemes: (a) Feeling helpless because nothing works; (b) Feeling down and depressed; (c) Distantly wishing for an end; (d) Accepting the reality of my pain; and (e) The pain stays, I keep going. Discussion and Implications This study contributes a vivid illustration of older adults’ CLBP illness experiences that are substantially underpinned by helplessness, depression, and a drive to continue thriving in old age. Practice implications include the need for clinic-based mood and suicide assessment.

scholarly journals Trunk Muscle Size and Composition Assessment in Older Adults with Chronic Low Back Pain: An Intra-Examiner and Inter-Examiner Reliability Study

Pain Medicine ◽  
2015 ◽  
Vol 17 (8) ◽  
pp. 1436-1446 ◽  
Author(s):  
Jaclyn Megan Sions ◽  
Andrew Craig Smith ◽  
Gregory Evan Hicks ◽  
James Matthew Elliott
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Trunk Muscle ◽  
Muscle Size ◽  
Low Back ◽  
Reliability Study

scholarly journals Mindfulness for Chronic Low Back Pain: A Qualitative Analysis

Pain Medicine ◽  
2017 ◽  
Vol 19 (11) ◽  
pp. 2138-2145 ◽  
Author(s):  
José G Luiggi-Hernandez ◽  
Jean Woo ◽  
Megan Hamm ◽  
Carol M Greco ◽  
Debra K Weiner ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Qualitative Analysis ◽  
Focus Groups ◽  
Chronic Low Back Pain ◽  
Complete Agreement ◽  
Low Back ◽  
Fear Of Pain ◽  
Body Therapy

Abstract Objective Mindfulness is a nonpharmacologic mind-body therapy that has been shown to be effective in older adults with chronic low back pain (cLBP). There are few first-person accounts in the literature that describe the older adult experience and perspective while learning mindfulness and meditation to treat pain. The objective of this study was to investigate dominant themes present in the experiences of older adults applying mindfulness and meditation to cope with cLBP. Design Qualitative analysis of four focus groups. Subject Twenty-five adults age 65 years or older who had completed an eight-week mindfulness program. Methods The focus groups met for a comprehensive discussion session about their experience with mindfulness and meditation. The audio for each session was recorded, and the discussions were transcribed. Codebook development, qualitative coding, and thematic analysis were performed. The coders each coded all four transcripts, following which they met to adjudicate all coding differences until they were in complete agreement on coding. Results Several key themes were brought up by older adults utilizing mindfulness as a means of coping with pain, which included overcoming fear of pain (“Before [learning mindfulness], I used to dread pain”), pain awareness (“You’re focusing more on being aware than the pain; now that’s what helps me”), and pain significance (“It becomes insignificant”). Conclusions The themes identify several ways mindfulness impacts older adults with cLBP, including decreased negative emotions related to chronic pain such as fear of pain, a different perspective or change in awareness about pain, and reducing the significance of pain.

scholarly journals A Prospective Randomized Controlled Study of Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: Study Protocol

2019 ◽  
Author(s):  
Chao Hsing Yeh ◽  
Cuicui Li ◽  
Ronald Glick ◽  
Elizabeth A. Schlenk ◽  
Kathryn Albers ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Comparison Group ◽  
Controlled Study ◽  
Low Back ◽  
Randomized Controlled ◽  
Auricular Point

Abstract Background: Chronic low back pain (cLBP) is a major health problem and the most common pain condition among those 60 years of age or older in the US. Despite the development of pharmacological and nonpharmacological interventions, cLBP outcomes have not improved and disability rates continue to rise. This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strategy to manage cLBP and to address current shortcomings of cLBP treatment. Methods: For this prospective randomized controlled study, participants will be randomly assigned into three groups: (1) APA (active points related to cLBP), (2) Comparison Group -1 (non-active points, unrelated to cLBP), (3) Comparison Group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessment smartphone app will be used to collect real-time cLBP outcomes and adherence to APA practice. Treatment and nonspecific psychological placebo effects will be measured via questionnaires for all participants. This proposed trial will evaluate the APA sustained effects for cLBP at 12-month follow-up. Monthly phone follow-up will be used to collect study outcomes. Blood will be collected during study visits at baseline, post-APA treatment, and follow-up study visits at 1-, 3-, 6-, 9- and 12-months post-completion of treatment for a total of 7 assessments. Appointments will start between 9 and 11 am to control for circadian variation in cytokine levels. Discussion: This study is expected to provide vital information on the efficacy, sustainability, and underlying mechanism of APA on cLBP necessary for APA to gain acceptance from both healthcare providers and patients, which would provide a strong impetus for including APA as part of cLBP management in clinical and home settings. Trial registration: NCT03589703, Registered on May 22, 2018 Keywords: Chronic low back pain, auricular point acupressure, older adults, cytokines

scholarly journals A Pain eHealth Platform for Engaging Obese, Older Adults with Chronic Low Back Pain in Nonpharmacological Pain Treatments: Protocol for a Pilot Feasibility Study

10.2196/14525 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e14525
Author(s):  
Amber K Brooks ◽  
David P Miller Jr ◽  
Jason T Fanning ◽  
Erin L Suftin ◽  
M Carrington Reid ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Primary Care Providers ◽  
Patient Portal ◽  
Low Back ◽  
Care Providers ◽  
Web Based

Background Low back pain is a costly healthcare problem and the leading cause of disability among adults in the United States. Primary care providers urgently need effective ways to deliver evidence-based, nonpharmacological therapies for chronic low back pain. Guidelines published by several government and national organizations have recommended nonpharmacological and nonopioid pharmacological therapies for low back pain. Objective The Pain eHealth Platform (PEP) pilot trial aims to test the feasibility of a highly innovative intervention that (1) uses an electronic health record (EHR) query to systematically identify a phenotype of obese, older adults with chronic low back pain who may benefit from Web-based behavioral treatments; (2) delivers highly tailored messages to eligible older adults with chronic low back pain via the patient portal; (3) links affected patients to a Web app that provides education on the efficacy of evidence-based, nonpharmacological, behavioral pain treatments; and (4) directs patients to existing Web-based health treatment tools. Methods Using a three-step modified Delphi method, an expert panel of primary care providers will define a low back pain phenotype for an EHR query. Using the defined low back pain phenotype, an EHR query will be created to identify patients who may benefit from the PEP. Up to 15 patients with low back pain will be interviewed to refine the tailored messaging, esthetics, and content of the patient-facing Web app within the PEP. Up to 10 primary care providers will be interviewed to better understand the facilitators and barriers to implementing the PEP, given their clinic workflow. We will assess the feasibility of the PEP in a single-arm pragmatic pilot study in which secure patient portal invitations containing a hyperlink to the PEP Web app are sent to 1000 patients. The primary outcome of the study is usability as measured by the System Usability Scale. Results Qualitative interviews with primary care providers were completed in April 2019. Qualitative interviews with patients will begin in December 2019. Conclusions The PEP will leverage informatics and the patient portal to deliver evidence-based nonpharmacological treatment information to adults with chronic low back pain. Results from this study may help inform the development of Web-based health platforms for other pain and chronic health conditions. International Registered Report Identifier (IRRID) DERR1-10.2196/14525

scholarly journals A Pain eHealth Platform for Engaging Obese, Older Adults with Chronic Low Back Pain in Nonpharmacological Pain Treatments: Protocol for a Pilot Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Amber K Brooks ◽  
David P Miller Jr ◽  
Jason T Fanning ◽  
Erin L Suftin ◽  
M Carrington Reid ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Primary Care Providers ◽  
Patient Portal ◽  
Low Back ◽  
Care Providers ◽  
Web Based

BACKGROUND Low back pain is a costly healthcare problem and the leading cause of disability among adults in the United States. Primary care providers urgently need effective ways to deliver evidence-based, nonpharmacological therapies for chronic low back pain. Guidelines published by several government and national organizations have recommended nonpharmacological and nonopioid pharmacological therapies for low back pain. OBJECTIVE The Pain eHealth Platform (PEP) pilot trial aims to test the feasibility of a highly innovative intervention that (1) uses an electronic health record (EHR) query to systematically identify a phenotype of obese, older adults with chronic low back pain who may benefit from Web-based behavioral treatments; (2) delivers highly tailored messages to eligible older adults with chronic low back pain via the patient portal; (3) links affected patients to a Web app that provides education on the efficacy of evidence-based, nonpharmacological, behavioral pain treatments; and (4) directs patients to existing Web-based health treatment tools. METHODS Using a three-step modified Delphi method, an expert panel of primary care providers will define a low back pain phenotype for an EHR query. Using the defined low back pain phenotype, an EHR query will be created to identify patients who may benefit from the PEP. Up to 15 patients with low back pain will be interviewed to refine the tailored messaging, esthetics, and content of the patient-facing Web app within the PEP. Up to 10 primary care providers will be interviewed to better understand the facilitators and barriers to implementing the PEP, given their clinic workflow. We will assess the feasibility of the PEP in a single-arm pragmatic pilot study in which secure patient portal invitations containing a hyperlink to the PEP Web app are sent to 1000 patients. The primary outcome of the study is usability as measured by the System Usability Scale. RESULTS Qualitative interviews with primary care providers were completed in April 2019. Qualitative interviews with patients will begin in December 2019. CONCLUSIONS The PEP will leverage informatics and the patient portal to deliver evidence-based nonpharmacological treatment information to adults with chronic low back pain. Results from this study may help inform the development of Web-based health platforms for other pain and chronic health conditions. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14525

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