How individuals with low back pain conceptualise their condition: A collaborative modelling approach, 2022, Hodges et al

Andy

Andy

Retired committee member
Highlights

  • We used collaborative modelling to evaluate how LBP patients conceptualize their condition
  • Patients created mental models with greatest weight on biomechanical factors
  • Patient views contrast the psychological bias of clinicians and researchers
  • Mental models can be used as a possible method to understand how patients view their condition

Abstract

Low back pain (LBP) is complex. This study aimed to use collaborative modelling to evaluate conceptual models that individuals with LBP have of their condition, and to compare these models with those of researchers/clinicians. Twenty-eight individuals with LBP were facilitated to generate mental models, using “fuzzy cognitive maps”, that represented conceptualisation of their own LBP and LBP “in general”. “Components” (i.e., causes, outcomes and treatments) related to pain, disability and quality of life were proposed, along with the weighted “Connections” between Components. Components were classified into thematic categories. Weighting of Connections were summed for each Component to judge relative importance. Individual models were aggregated into a metamodel. When considering their own condition, participants’ models included 19(SD=6) Components and 43(18) Connections with greatest weight on “Biomechanical” components. When considering LBP in general, models changed slightly. Patient models contrasted the more complex models of researchers/clinicians (25(7) Components; 77(42) Connections), with most weight on “Psychological” components. This study provides unique insight into how individuals with LBP consider their condition, which is largely biomedical and narrower than clinician/researcher perspectives. Findings highlight challenges for changing public perception of LBP, and provide a method with potential utility to understand how individuals conceptualise their condition.

Paywall, https://www.jpain.org/article/S1526-5900(22)00010-4/fulltext
 
That final sentence in the abstract seems to imply that the clinicians are right to put more weight on psychological explanations for low back pain, and the problem is persuading patients and the public they are right.
Surely they need to consider the problem with medical education that places too much weight on psychological explanations for things they can't see in a test.
 
Exactly. The unspoken arrogance is breathtaking. Patients know what they are thinking and feeling while the doctors are just believing what they have been told.

It could rightly be said that they understand biology and anatomy better than the patient but it is conspicuous that these beliefs are held most strongly about conditions where the biology is not well understood. In conditions where more is known about what is happening in the body there is not the same emphasis on psychological factors.
 
hellytheelephant said:
I honestly don't think I have ever ' conceptualised ' my back pain. It is pain ( aka. Reality) not an abstract idea I have cobbled together.
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It's obviously not a thing people do. It just exists in this weird context where incompetent people try to invent alternative explanations for simple concepts. Framing back pain as complex is the same as calling common symptoms of illness "vague", it's just trying too hard to reframe it unnecessarily in psychological terms.

This is the same junk as calling poverty a lifestyle choice, that there are people who are just limited to not accomplish anything and thus live in poverty. They're trying to invent narratives for why people are being failed, because it is their failure, and they can't accept that. So they blame others, anyone, anything.
 
What a whole load of twaddle. My back went 3 days ago and I've been flat on it ever since. It never occurred to me to generate a mental model or conceptualise it. Just a case of taking the ibuprofen, waiting for it to right itself, and avoiding other people's back stories in the meantime.

Is writing this drivel an actual job? To what purpose?

Anyway, the good news is that I'm able to think it away again over a week or so. Thank goodness for the amazing mind-body connection.
 
shak8 said:
I think it best to go back walking on all-fours and relieve the fascinating researchers of their subject matter.
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Brachiating from tree to tree is the answer. That’s what our anatomy is designed for, and we’re clearly unsuited to walking on hind legs, whether because of boring biomechanical issues like pressure on spinal discs, or more floridly Freudian reasons like bipedal anxiety which presents somatically.
 
Of course, implied is their theory " learn to control, reduce your pain through your psychological well-being ". Well, what if I'm in pain and I'm still in a good mood and relaxed ? I assure you, that's my state of being most of the time. Persuading people that physical pain is always also psychological, what a dangerous alternative fact ! Again, the magical powers of the mind ! I would bet none of these authors know what they are talking about, i.e. have no personal experience with chronic pain, year after year.
 
Shadrach Loom said:
Brachiating from tree to tree is the answer. That’s what our anatomy is designed for, and we’re clearly unsuited to walking on hind legs, whether because of boring biomechanical issues like pressure on spinal discs, or more floridly Freudian reasons like bipedal anxiety which presents somatically.
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thanks for that. Guess that's why I residually love trees so much.
 
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