Chasing the ghosts: The impact of diagnostic labelling on self-management and pain-related guilt in chronic low back pain patients.

Danijela Serbic, Tamar Pincus

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clear diagnosis cannot be established; as a result patients
are given labels such as non-specific low back pain. There
is some evidence to suggest that lack of a clear diagnosis is
associated with negative psychological, clinical and
behavioural outcomes. The main aim of this study was to
examine CLBP patients’ understanding, feelings and
behaviour in response to their diagnostic labels. Semistructured
interviews were conducted with twenty CLBP
patients who were recruited from one osteopathic and one
pain management clinic in the UK. Sampling, data
collection and analysis were driven by a grounded theory
approach. Data were analysed through four stages of
coding: open, selective, axial and theoretical coding. Data
collection and coding continued until data achieved
saturation. Results indicated that lack of a clear diagnosis is
associated with distress, further treatment seeking and
uncertainty. It also influenced participants’ perception of
their social relationships; having visible evidence and a
clear diagnosis gave patients’ pain more social credibility.
Participants reported feeling guilty about the consequences
of their pain to themselves and others, and for failing to
recover. Overall, participants’ narratives suggest that at
least for some, absence of a clear diagnosis has
considerable negative implications. The goal of the study
was to inform clinicians and policy makers about the
impact of diagnosis on CLBP patients’ adjustment and
emotional burden; findings suggest that legitimising the
pain experience is of prime importance to CLBP patients.
Original languageEnglish
Pages (from-to)25-35
JournalJournal of Pain Management
Issue number1
Publication statusPublished - 2013


  • Chronic low back pain, diagnosis, pain-related

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