Exploring Self-Management Barriers and Facilitators Experience by People with Chronic Musculoskeletal Pain - A Qualitative Study

Background: One in three people worldwide will experience chronic musculoskeletal pain (CMP). Due to the long-standing nature of CMP, it is inevitable that people with CMP will have to engage in some form of self-management. As highlighted by multiple clinical practice guidelines, it becomes pivotal that healthcare professionals provide effective self-management support. However, the current effectiveness of self-management interventions seems equivocal. This may be due to self-management interventions not being developed based on an in-depth understanding of the self-management challenges experienced by people with CMP. Objectives: This study explored the everyday barriers and facilitators for self-management experienced by people with CMP currently undergoing rehabilitation in a municipality setting. Methods: We conducted 11 one-time, single-person, qualitative interviews of people living with CMP. The interviews were based on a semi-structured interview guide with open-ended questions and analyzed using an inductive thematic analysis to identify the participants experienced barriers and facilitators for self-management in everyday situations. Findings: Three overarching barriers emerged: 1) biographical disruption, 2) uncertainty and psychological distress, and 3) lack of social support. Further, three overarching facilitators emerged: 1) acceptance and optimism 2) pain-relieving strategies and 3) social support. These barriers and facilitators far exceeded participants capability to control their pain. Conclusion: The majority of the barriers and facilitators concerned the management of cognitive, emotional, social or personal consequences of CMP. Integrating these barriers and facilitators into the development of future self-management interventions may have the potential to improve the effectiveness of these interventions.