Navigating back pain care: A sociological study of women's illness pathways within and between intersecting social worlds

Back pain represents a key public health problem for the Australian health system, and the significance of back pain for Australian primary care delivery is evident in the fact that it is the second most common complaint in general practice consultations. Back pain carries both high direct and indirect costs, including reduced capacity to work and participate in community life. For some back pain sufferers conventional treatments have limited therapeutic effect, leading often to the use of various ‘alternatives’. Back pain care is delivered primarily by GPs, physiotherapists, chiropractors, osteopaths, acupuncturists, and massage therapists. Yet the actual usage and popularity of such modalities amongst Australians remains relatively unknown.

This paper focuses on an analysis of data from a national, representative cross-sectional survey on the practices and providers mid-age Australian women with back pain are utilising in their care. This sociological study examines such things as:  use of providers and self-delivered care; the bases of decisions and trajectories; issues related to cost, risk and choice; and, ultimately these women's pathways through care. This represents a major sub-study of the Australian Longitudinal Study on Women's Health (n=40,000) of which around 1,800 mid-age women participated given their existing back pain. Here we report on the extent of plurality of available treatment options for mid-age Australian women with back pain, and assess their experiences of utilising multiple biomedical, allied health and complementary providers to address their pain and quality of life/wellbeing. A particular focus is on women’s access and decision-making regarding practitioner choice and consultation, and perceptions of the value of a variety of biomedical and complementary providers.