421: Pain beliefs and coping strategies among Nepali adults with low back pain: A Qualitative Study

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Psychology, Physiotherapy

Background and Aims: Background
Chronic low back pain (CLBP) is a common disabling condition. A complex set of biological, psychological and social factors contributes to CLBP and its persistence. Data from western literature show that two categories of psychological factors are considered important contributors, namely pain beliefs and pain coping responses. However, data from non-Western contexts are currently lacking, while these issues are not yet explored in individuals with CLBP in Nepal.
Aim
This study aimed to better understand pain beliefs and coping strategies among Nepali adults with CLBP.

Methods: A phenomenological qualitative research design was used. In-depth individual interviews were conducted using a semi-structured interview guide which was based on Leventhal's Common Sense Model. A total of 16 participants were interviewed until information saturation. Reflexive thematic analysis was used to analyse data with inductive coding followed by deductive coding.

Results: Four pain-belief-related themes: (1) Biological, (2) Behavioural, (3) Psychological, and (4) Social-cultural beliefs related to low back pain. Two main coping themes: (1) Active coping and (2) Passive coping strategies to help manage pain. Each theme encapsulated three to ten categories expanding from common beliefs and coping approaches universally (e.g., biological pain belief and medication) and potentially unique to Nepali or South Asian cultures (e.g., superstitious belief and Ayurvedic medicine). Several concepts intersected providing evidence that pain is outcome of complex sets of interplay of biological, psychological, social, behavioural, and cultural domains, with mix of both helpful and unhelpful beliefs and coping.

Conclusions: The findings reinforce uniqueness of each individual’s world views around pain and how they contribute to the way they respond to their pain. The results underscore the importance of culturally tailored evidence-based biopsychosocial approaches to managing CLBP.

References: 1. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet (England). 2018;391(10137):2356-67.
2. Morton L, De Bruin M, Krajewska M, Whibley D, Macfarlane G. Beliefs about back pain and pain management behaviours, and their associations in the general population: A systematic review. European Journal of Pain. 2019;23(1):15-30.
3. Leventhal H, Phillips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. Journal of behavioral medicine. 2016;39:935-46.
4. Byrne DJQ, quantity. A worked example of Braun and Clarke’s approach to reflexive thematic analysis. 2022;56(3):1391-412.

Presenting Author: Ritu Basnet
Submitting Author: Ritu Basnet

Senior Author: Saurab Sharma

IASP 2026 Global Year theme of Neuropathic Pain: No

• Mark P. Jensen: PhD - Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
• Anupa Pathak: PhD - School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia
• Saroj Prasad Ojha: MD - Department of Psychiatry and Mental Health, Maharajgunj Medical Campus, Institute of Medicine, Nepal
• Mita Rana: PhD - Department of Psychiatry and Mental Health, Maharajgunj Medical Campus, Institute of Medicine, Nepal
• Suraj Shakya: PhD - Department of Psychiatry and Mental Health, Maharajgunj Medical Campus, Institute of Medicine, Nepal
• Prayoush Neupane: MD - Department of Physiotherapy, Maharajgunj Medical Campus, Institute of Medicine, Nepal
• Sonu Maharjan: BPT - Department of Kinesiology, University of Texas at Austin, Texas, USA
• Saurab Sharma: PhD - Pain Management and Research Centre, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia