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The power of the visible: the meaning of diagnostic tests in chronic back pain

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  • Rhodes, Lorna A.
  • McPhillips-Tangum, Carol A.
  • Markham, Christine
  • Klenk, Rebecca

Abstract

This article explores the meaning of diagnostic tests for people with chronic back pain. Lower back pain is one of the most common health problems in the US. Five to ten percent of the patients who visit a primary care provider for back pain ultimately develop a chronic condition. We draw on interviews with chronic back pain patients in Atlanta, Dallas and Seattle to argue that testing constitutes an important element in the legitimation of pain for these patients. We discuss three aspects that make testing an area of concern for patients: a strong historical connection between visual images and the medicalization of the interior of the body, a set of cultural assumptions that make seeing into the body central to confirming and normalizing patients' symptoms, and the concreteness of diagnostic images themselves. Our interviews show that when physicians cannot locate the problem or express doubt about the possibility of a solution, patients feel that their pain is disconfirmed. Faced with the disjunction between the cultural model of the visible body and the private experience of pain, patients are alienated not only from individual physicians but from an important aspect of the symbolic world of medicine. This paper concludes by suggesting that a fluid, less localized understanding of pain could provide a greater sense of legitimacy for back pain patients.

Suggested Citation

  • Rhodes, Lorna A. & McPhillips-Tangum, Carol A. & Markham, Christine & Klenk, Rebecca, 1999. "The power of the visible: the meaning of diagnostic tests in chronic back pain," Social Science & Medicine, Elsevier, vol. 48(9), pages 1189-1203, May.
    • Handle: RePEc:eee:socmed:v:48:y:1999:i:9:p:1189-1203
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    Cited by:

    1. Naraindas, Harish, 2006. "Of spineless babies and folic acid: Evidence and efficacy in biomedicine and ayurvedic medicine," Social Science & Medicine, Elsevier, vol. 62(11), pages 2658-2669, June.
    2. Buchbinder, Mara, 2015. "Neural imaginaries and clinical epistemology: Rhetorically mapping the adolescent brain in the clinical encounter," Social Science & Medicine, Elsevier, vol. 143(C), pages 304-310.
    3. 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.
    4. Higgins, Angela & Porter, Sam & O'Halloran, Peter, 2014. "General practitioners' management of the long-term sick role," Social Science & Medicine, Elsevier, vol. 107(C), pages 52-60.
    5. Natalie Tyldesley-Marshall & Sheila Greenfield & Susan J. Neilson & Jenny Adamski & Sharon Beardsmore & Martin English & Andrew Peet, 2020. "Exploring the Role of ‘Shadowing’ as a Beneficial Preparatory Step for Sensitive Qualitative Research with Children and Young People with Serious Health Conditions," Societies, MDPI, vol. 10(1), pages 1-14, January.
    6. Gardner, John & Dew, Kevin & Stubbe, Maria & Dowell, Tony & Macdonald, Lindsay, 2011. "Patchwork diagnoses: The production of coherence, uncertainty, and manageable bodies," Social Science & Medicine, Elsevier, vol. 73(6), pages 843-850, September.
    7. Sim, Julius & Madden, Sue, 2008. "Illness experience in fibromyalgia syndrome: A metasynthesis of qualitative studies," Social Science & Medicine, Elsevier, vol. 67(1), pages 57-67, July.
    8. Greco, Monica, 2012. "The classification and nomenclature of ‘medically unexplained symptoms’: Conflict, performativity and critique," Social Science & Medicine, Elsevier, vol. 75(12), pages 2362-2369.
    9. Nettleton, Sarah, 2006. "'I just want permission to be ill': Towards a sociology of medically unexplained symptoms," Social Science & Medicine, Elsevier, vol. 62(5), pages 1167-1178, March.
    10. Reventlow, Susanne Dalsgaard & Hvas, Lotte & Malterud, Kirsti, 2006. "Making the invisible body visible. Bone scans, osteoporosis and women's bodily experiences," Social Science & Medicine, Elsevier, vol. 62(11), pages 2720-2731, June.
    11. Copelton, Denise A. & Valle, Giuseppina, 2009. ""You don't need a prescription to go gluten-free": The scientific self-diagnosis of celiac disease," Social Science & Medicine, Elsevier, vol. 69(4), pages 623-631, August.

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