Daily occupations with or without pain: Dilemmas in occupational performance

This explorative study examined the influence of chronic lower back pain on the motives for occupational performance. A narrative interview was conducted with seven Dutch clients. Three phases in the process of living with lower back pain were identified in which the self the pain, and the environment were seen as interrelated elements that influence the creation of motives. In the first phase, clients wanted to meet social and personal expectations, which led to their ignoring the lower back pain. In the second phase, the pain took control and the clients withdrew from social participation, which led to "emotional pain." In the third phase, clients became more conscious of the dynamics and dilemmas between the self, the pain, and the environment. Analysis of study results suggests that clients' narratives can help occupational therapists gain a deeper understanding of clients' experiences of dealing with chronic pain.