Summary: | The purpose of this study was to explore personal accounts of acute non-specific low back pain experiences to gain insights and extend knowledge for physiotherapy practice and research. At present, knowledge of acute low back pain and understandings of the transition from acute to chronic low back problems largely derives from experimental research and population-generated findings developed from self-report questionnaires. Despite extensive research, there remains a limited ability to prevent the transition from acute low back pain problems to chronic pain and long term disability in many individuals. A qualitative study of personal accounts of acute low back pain experiences was undertaken using a theoretical perspective drawn from narrative research and discourse analysis. The approach incorporated narrative theory and perspectives from social constructionism, post-structuralism and theory of language. Nineteen participants with acute non-specific low back pain problems (< 6 weeks) were followed through to recovery or to three months with persisting problems, considered as the transition to `chronicity'. Data was generated through repeated interviews and written personal accounts involving a reflective timeline and a seven day open-format diary. Data analysis applied a narrative-discursive approach, and in particular a combined micro-interactional and macro-social approach drawn from discursive psychology. The nature of personal accounts of acute low back pain experiences has been shown to be significantly more complex than previously described within physiotherapy or low back pain literature. As personal circumstances were characterised so as to be appreciated as a significant problem, the accounts were constructed with qualities to support the credibility of the information. The accounts were also shaped to manage impressions of personal character, moral integrity, and personal accountability. In addition, considerations provided by the broader and situated social context, social relations and the unfolding interaction influenced the nature of the accounts. Finally, time was also an integral feature to the nature of the accounts, as a changing social context, an entity of personal and social significance and for its use as a resource for conveying meanings. This complexity has important implications for the interpretation of accounts and for the kind of knowledge assumed possible. Understanding the complexity also supports a more informed approach to the generation, interpretation and use of personal accounts as a form of information within practice and research contexts. The value of the methodology used in this study and the incorporation of theory and understandings from other disciplines for extending knowledge for physiotherapy practice is also discussed. 2
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