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Medical knowledge and the intractable patient: the case of chronic low back pain

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  • May, Carl
  • Doyle, Helen
  • Chew-Graham, Carolyn

Abstract

Chronic low back pain (CLBP) is endemic in Western societies, and while a good deal of attention has been paid to the lay experience of such pain, much less sociological attention has been paid to the way in which medical ideas about it have been formulated. This paper takes the latter course, tracing the development of clinical notions about the relationship between pathological signs and expressed symptoms from the 1820's to the 1930's, and then placing these developments in the context of postwar notions of 'somatization'. We point to the extent to which the disparity between expressed symptoms, pathological signs and perceived disability in CLBP has led to the moral character of the sufferer forming a constant subtext to medical discourse about the condition. We also note the extent to which medical ideas themselves have been constructed in intimate linkage with socio-legal questions of compensation and worker's insurance.

Suggested Citation

  • May, Carl & Doyle, Helen & Chew-Graham, Carolyn, 1999. "Medical knowledge and the intractable patient: the case of chronic low back pain," Social Science & Medicine, Elsevier, vol. 48(4), pages 523-534, February.
    • Handle: RePEc:eee:socmed:v:48:y:1999:i:4:p:523-534
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    Cited by:

    1. Wilson, Nicky & Pope, Catherine & Roberts, Lisa & Crouch, Robert, 2014. "Governing healthcare: Finding meaning in a clinical practice guideline for the management of non-specific low back pain," Social Science & Medicine, Elsevier, vol. 102(C), pages 138-145.
    2. Corbett, Mandy & Foster, Nadine E. & Ong, Bie Nio, 2007. "Living with low back pain--Stories of hope and despair," Social Science & Medicine, Elsevier, vol. 65(8), pages 1584-1594, October.

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