The coping strategies employed by individuals with chronic low back pain: secondary qualitative analysis of data from diverse adult populations in two sub-Saharan African countries.
Chinonso Nwamaka Igwesi-Chidobe, Loveness A Nkhata, Benjamin Ozumba
PMID 39635506WHAT IT FOUND
Adults in Nigeria and Zambia mixed helpful and harmful strategies to manage back pain.
Avoiding heavy lifting and pacing work helped, but poverty forced many to keep lifting. Relying on painkillers for daily function was common, and no strategy fully stopped the pain.
Key findings
01Most participants used a combination of adaptive and maladaptive coping strategies simultaneously rather than one type exclusively.
02Avoiding heavy manual labor provided long-lasting pain relief, but financial and family obligations made this strategy difficult to sustain for many participants.
03Relying on over-the-counter analgesic drugs to maintain daily function was a common maladaptive strategy, and no participant reported complete resolution of their back pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a secondary analysis of data collected for different primary purposes, so the original interviews did not specifically probe the trajectories of coping strategy changes. The two groups were vastly different in occupation and setting (rural farmers vs. urban nurses), which confounds the comparison of coping strategies. Pain intensity and comorbidity data were not collected for the Zambian participants, and pain history was not collected for the Nigerian participants. The authors led the primary studies, which the paper claims avoids interpretation bias, but this also means the same researchers interpreted the data twice. Findings are from specific African contexts and may not generalize to patients in high-income countries with different social safety nets.
Declared interests
The lead author received a personal grant from the 2020 Nature Research Award for Driving Global Impact. No commercial funding or conflicts of interest were declared.
The easy way to misread this
Do not interpret the use of spiritual coping or analgesic reliance as universally maladaptive. The study found that the effectiveness of these strategies varied by individual and context, and spiritual practices provided genuine psychological relief for some participants despite being categorized as maladaptive in other frameworks.