Disrupted everyday life in the trajectory of low back pain: A longitudinal qualitative study of the cross-sectorial pathways of individuals with low back pain over time

Background: Low back pain is a leading cause of disability and sick days worldwide. This type of pain has a fluctuating and recurrent nature, and affects all aspects of a person's life, with profound psychosocial consequences.Objectives: This study aims to explore the everyday life of individuals with low back pain over time and across various contexts.Design: A longitudinal Grounded Theory study with the concept, conduct of everyday life, as the theoretical framework. Settings: The study was conducted in Denmark, and participants were sampled from a regional spine centre in a hospital context. Participants: Twenty-seven individuals with low back pain referred to a hospital for assess-ment and treatment for herniated discs were sampled. Participants were divided equally between women and men 37-71 years old.Method: Participants were followed through interviews and participant observation for 6-18 months. They were interviewed at least twice, at the beginning and end of the study period. The interviews took place in participants' homes. Data consisted of transcribed interviews and field notes.Results: Two themes, "When 'support' systems become disrupters " and "Adapting to a new life ", de-scribe important elements of the participants' conduct of everyday life through a period of low back pain and the time after. The first theme explains how healthcare and sickness benefit sys-tems play an existential role in the individual's life during a period of low back pain. These systems made extensive, often conflicting, demands on participants, which challenged their ev-eryday lives. The systems and their diverse needs could take precedence over other concerns, challenging participants' social self-understanding. In the second theme, we identified three typ-ical patterns of how participants adapt to living with a potential exacerbation of low back pain over time: 1) Resignation, 2) Balancing and 3) Ignoring.Conclusions: From the participants' perspectives, healthcare and sickness benefits systems are supportive, but they often disrupt everyday life due to extensive and conflicting demands. Individuals with low back pain must continually adapt to everyday life. Therefore, professionals should support a balanced pattern of adapting to life with recurrent and fluctuating low back pain.