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Back pain and the resolution of diagnostic uncertainty in illness narratives

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  • Lillrank, Annika

Abstract

In this paper I consider 30 Finnish women's written narratives about the process of getting back pain diagnosed. From the beginning of the early discomfort of back pain, the women were sure of its bodily and subjective reality. They struggled repeatedly to be taken seriously, and only after years of medical disparagement did they encounter medical professionals who were able solve the riddle and give it a name, a diagnosis. Since back pain is a baffling problem and challenges the central biomedical epistemology--objective knowledge and measurable findings separate from subjective experience--it allowed the doctors to show a disrespectful attitude toward back pain sufferers. The moral essence of the women's common story was the stigmatizing experience when doctors did not take subjective pain seriously. Instead, doctors' neglectful attitudes became part of the prolonged problem. During the long-lasting uncertainty, women tried multiple coping strategies to ease their lives and developed mental attitudes to endure the pain. Since the protagonists did not give up the lived certainty of back pain they were gradually able to challenge medical uncertainty and to demand a thorough medical examination, and/or through random circumstance they encountered doctors who were willing to take their symptoms seriously. This triggered turning points that immediately or very soon resulted in solving the riddle of the puzzling pain. To be finally diagnosed was a great relief. However, to be taken seriously as a person was considered to be the greatest relief.

Suggested Citation

  • Lillrank, Annika, 2003. "Back pain and the resolution of diagnostic uncertainty in illness narratives," Social Science & Medicine, Elsevier, vol. 57(6), pages 1045-1054, September.
    • Handle: RePEc:eee:socmed:v:57:y:2003:i:6:p:1045-1054
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    Cited by:

    1. Inge M Brokerhof & Jan Fekke Ybema & P Matthijs Bal, 2020. "Illness narratives and chronic patients’ sustainable employability: The impact of positive work stories," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-17, February.
    2. Miles, A. & Curran, H.V. & Pearce, S. & Allan, L., 2005. "Managing constraint: the experience of people with chronic pain," Social Science & Medicine, Elsevier, vol. 61(2), pages 431-441, July.
    3. Willig, Carla, 2011. "Cancer diagnosis as discursive capture: Phenomenological repercussions of being positioned within dominant constructions of cancer," Social Science & Medicine, Elsevier, vol. 73(6), pages 897-903, September.
    4. Melander, Stina, 2023. "Different logics of pain: the gendered dimension of chronic pain in a relational setting," Social Science & Medicine, Elsevier, vol. 335(C).
    5. Koekkoek, B. & Hutschemaekers, G. & van Meijel, B. & Schene, A., 2011. "How do patients come to be seen as 'difficult'?: A mixed-methods study in community mental health care," Social Science & Medicine, Elsevier, vol. 72(4), pages 504-512, February.
    6. Sung Soo Lim, 2020. "The Effects of Chronic Illness on Aspirations and Subjective Wellbeing," Journal of Happiness Studies, Springer, vol. 21(5), pages 1771-1793, June.
    7. Kielmann, Karina & Deshmukh, Deepali & Deshpande, Sucheta & Datye, Vinita & Porter, John & Rangan, Sheela, 2005. "Managing uncertainty around HIV/AIDS in an urban setting: Private medical providers and their patients in Pune, India," Social Science & Medicine, Elsevier, vol. 61(7), pages 1540-1550, October.
    8. Whitmarsh, Ian & Davis, Arlene M. & Skinner, Debra & Bailey, Donald Jr., 2007. "A place for genetic uncertainty: Parents valuing an unknown in the meaning of disease," Social Science & Medicine, Elsevier, vol. 65(6), pages 1082-1093, September.
    9. Guntram, Lisa, 2013. "“Differently normal” and “normally different”: Negotiations of female embodiment in women's accounts of ‘atypical’ sex development," Social Science & Medicine, Elsevier, vol. 98(C), pages 232-238.
    10. Costa, Nathalia & Mescouto, Karime & Dillon, Miriam & Olson, Rebecca & Butler, Prudence & Forbes, Roma & Setchell, Jenny, 2022. "The ubiquity of uncertainty in low back pain care," Social Science & Medicine, Elsevier, vol. 313(C).
    11. Dumit, Joseph, 2006. "Illnesses you have to fight to get: Facts as forces in uncertain, emergent illnesses," Social Science & Medicine, Elsevier, vol. 62(3), pages 577-590, February.
    12. Richardson, Jane C. & Ong, Bie Nio & Sim, Julius, 2006. "Is chronic widespread pain biographically disruptive?," Social Science & Medicine, Elsevier, vol. 63(6), pages 1573-1585, September.
    13. 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.
    14. 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.
    15. Brown, Eliza, 2020. "Projected diagnosis, anticipatory medicine, and uncertainty: How medical providers ‘rule out’ potential pregnancy in contraceptive counseling," Social Science & Medicine, Elsevier, vol. 258(C).
    16. Paul Atkinson, 2009. "Illness Narratives Revisited: The Failure of Narrative Reductionism," Sociological Research Online, , vol. 14(5), pages 196-205, November.

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