I've just done my afternoon clinic in my GP practice. I saw three cases of low back pain. All had a similar story: a person of working age, in a sedentary job, who spent a long time every day sitting at the computer and also in their cars driving to and from work. The 'cause' of the low back pain in each case was partly physical (immobility, unnatural posture) but also had a societal cause (the change in our work and lifestyles that's happened in UK in the past 30 years). They all expected an X-ray or a scan. All were wondering whether to take time off work, and one of them also asked for a 'certificate' to get a refund of her gym membership because she thought she should rest her painful back! Sociologically, these (flawed) expectations and assumptions (actually, the best treatment for mild low back pain is take exercise; the appropriate management is to adjust the person's work and driving positions to get a better ergonomic position, and an X-ray isn't going to help much) are part of what might be called the 'lay epidemiology' of low back pain. They also show the negotiation of the sick role: the patients in this case were all contemplating withdrawing from their work or social activities, but I refused to legitimate their illness and instead encouraged them to keep moving and keep going to work! I also printed off patient information leaflets in the hope that they will become more informed, empowered and 'expert'.
Do share other examples BUT START A NEW THREAD unless replying to my example.
