JMIR Publications

ABSTRACT

Low back pain (LBP) is a world leading cause of disability with huge social and economic impact. We aimed to scrutinise some of the conceptual tensions inherent in contemporary LBP healthcare approaches, and to highlight their material effects. We used a qualitative research design adapted from discourse analysis to consider key discursive ‘tensions’ underpinning a website which was developed based on contemporary LBP approaches. Data collection involved observing the interaction between adult participants with LBP and the website by: 1) observational interviews while participants interacted with the website for the first time; and 2) photo-elicitation where people took photographs of what was happeing when they thought of the website. Our post-critical discourse analysis identified key discursive ‘tensions, including between: living with and reducing LBP; keeping active and resting; and patient choice and giving guidance. Although the focus of LBP discourses have changed (less biomedical, less about cure) they still hold on to some of the problematic dominant paradigmatic concepts such as biomedicine and individualism. The ‘tensions’ we highlight are likely to be highly useful for teaching and implementing LBP care across multiple healthcare settings.