Journal of Occupational Rehabilitation

, Volume 21, Issue 3, pp 395–409 | Cite as

Rural Workers’ Experience of Low Back Pain: Exploring Why They Continue to Work

  • Sarah G. Dean
  • Sheena Hudson
  • E. Jean C. Hay-Smith
  • Stephan Milosavljevic


Introduction Many New Zealand rural workers have repeated low back pain (LBP) episodes yet continue to work. We wanted to find out why, given that other manual workers with LBP often end up on long term sick leave or permanently disabled. Methods Our primarily qualitative approach used mixed methods to investigate rural workers with non-specific LBP. Participants (n = 33) were surveyed for demographic data, the Brief Illness Perception Questionnaire and the General Self Efficacy Scale followed by one-to-one semi-structured interviews. Analysis ranged from descriptive content to detailed qualitative Interpretative Phenomenological Analysis. Results Participants had high self efficacy scores, positive perceptions about LBP but strong beliefs that LBP is lifelong. Four distinct themes emerged. “Thinking with my head before my back” and “Knowing the risks” described participants’ innovation regarding job modifications. “Just carry on” and “Love of the land” related to stoical resilience and commitment to something more than employment. Conclusions This rural workforce adopts a ‘can do’ attitude to work, managing LBP within the context of having job control and flexible work practices. Implications: Rehabilitation interventions promoting job control and targeting positive attitudes towards getting on with work, whilst accepting LBP as part of everyday life, may have merit for other workers with LBP.


Low back pain Workers Psychology Interpretative phenomenological analysis Mixed methods research  



Funding support for conducting the study was provided by a University of Otago NZ, Research Grant and the lead author’s time is now supported by funding from the National Institute for Health Research UK, in connection with her role within the Peninsula Collaboration for Leadership in Applied Health Research and Care.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Sarah G. Dean
    • 1
    • 2
  • Sheena Hudson
    • 2
  • E. Jean C. Hay-Smith
    • 2
  • Stephan Milosavljevic
    • 3
  1. 1.Peninsula College of Medicine and DentistryUniversity of ExeterExeterUK
  2. 2.Rehabilitation Teaching and Research Unit, Department of MedicineUniversity of Otago, WellingtonWellington SouthNew Zealand
  3. 3.Centre for Physiotherapy Research, School of PhysiotherapyUniversity of Otago, DunedinDunedinNew Zealand

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