IDEAS home Printed from
   My bibliography  Save this article

Talking about the pain: A patient-centered study of low back pain in primary care


  • Borkan, Jeffrey
  • Reis, Shmuel
  • Hermoni, Doron
  • Biderman, Aya


Despite considerable research, low back pain (LBP) often proves resistant to treatment. This study was designed to increase the understanding of low back pain through access to patients' perceptions, beliefs, illness behaviors and lived experiences. The findings are based on focus groups, individual interviews and participant observation conducted in primary care practices and community settings in three regions in Israel. Inclusion criteria for the interviews and groups include age greater than 18 years and a history of at least one episode of LBP. Seventy-six LBP subjects between the ages of 18 and 67 (mean 39.5) participated, 65% male and 35% female. The analytic method is content analysis, consisting of a formal, multi-step process designed to elucidate inherent patterns and meanings. This research finds that LBP subjects articulate a rich world of pain sensation, awareness and meanings. From subjects' own words and experiences we present a patient-centered classification system of backache symptoms based on typical pain intensity, dysfunction, duration and treatment. An elaborate system of explanatory models of LBP and a typology of dominant coping styles designed to either minimize pain or maximize function are also derived. Subjects choose multiple conventional and alternative treatments based on "what works," and articulate ample criticisms of and suggestions for the medical system. In addition, we find that variations in the social construction of the back pain experience vary sharply, even between similar neighboring communities. Given the difficult state of diagnosis and treatment and the frustration of practitioners, attempts at greater understanding of patients' health beliefs, experiences, and behaviors are warranted. Reaching agreement between health provider and patient and addressing patient belief systems may improve outcomes.

Suggested Citation

  • Borkan, Jeffrey & Reis, Shmuel & Hermoni, Doron & Biderman, Aya, 1995. "Talking about the pain: A patient-centered study of low back pain in primary care," Social Science & Medicine, Elsevier, vol. 40(7), pages 977-988, April.
  • Handle: RePEc:eee:socmed:v:40:y:1995:i:7:p:977-988

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Halkos, George, 1993. "Economic incentives for optimal sulphur abatement in Europe," MPRA Paper 33705, University Library of Munich, Germany.
    2. Ger Klaassen & David Pearce, 1995. "Introduction," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 5(2), pages 85-93, March.
    3. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, January.
    4. Tietenberg, T H, 1990. "Economic Instruments for Environmental Regulation," Oxford Review of Economic Policy, Oxford University Press, vol. 6(1), pages 17-33, Spring.
    5. Halkos, George E., 1993. "Sulphur abatement policy: Implications of cost differentials," Energy Policy, Elsevier, vol. 21(10), pages 1035-1043, October.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Richardson, Jane C. & Ong, Bie Nio & Sim, Julius, 2006. "Is chronic widespread pain biographically disruptive?," Social Science & Medicine, Elsevier, vol. 63(6), pages 1573-1585, September.
    2. Corbett, Mandy & Foster, Nadine E. & Ong, Bie Nio, 2007. "Living with low back pain--Stories of hope and despair," Social Science & Medicine, Elsevier, vol. 65(8), pages 1584-1594, October.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:40:y:1995:i:7:p:977-988. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.