We conducted a content analysis to describe posts about low back pain on social media geo-targeted to Australia. The results provide a snapshot of what is relevant for people with low back pain, thereby accessing an otherwise undisclosed insight to direct patient-centred care.

We used a conventional content analysis method. We searched social media platforms Twitter, Facebook and Instagram using keywords from previously published back pain research. A media team collected the data using software called NUVI. NUVI is a social listening platform that specialised in data collection and analysis from social media.

We collated original posts, called status broadcasts, with a low back pain keyword and any response to the status broadcast. Three researchers performed the coding in keeping with standard content analysis practices. Coding was divided into phases, starting with familiarisation, where the coding researchers read the data to understand it. Next, we applied codes to the data and then arranged the codes into categories, abstracting exemplars for each category. Finally, we decided on themes to represent the categories. It was an iterative process, refined through discussion.

We collected data over 66 days from the social media platforms Twitter and Instagram. We were not able to access data from Facebook due to privacy restrictions. In total, we collected 768 posts, including 457 status broadcasts and 311 responses. The data were coded, and two themes were identified; “Hear my pain” and “I feel for you”.

The categories that contributed to “Hear my pain” were; 1. seek validation, 2. express anger and 3. seek understanding. We found that almost half (49%) of the status broadcasts about low back pain on social media appeared to be from people seeking validation for their symptoms. Such as in the example;

“When the pain in your lumbar spine is so bad that all you can do is softly cry. Yeah that”

People expressed anger in 11% of status broadcasts;

“Hm. Coo. So if my back is so sore that I can’t move tomorrow, I don’t qualify for special consideration for missing my exam. COOL.”

and sought understanding in the form of advice or help in 8% of the status broadcasts;

“A few weeks ago, I twinged my back lifting an 11kg kayak off the car. I’m not sure who I am anymore”.

The categories that contributed to the theme “I feel for you” were; 1. sympathy, 2. shared experience, and 3. empathy. We found that sympathy was the most common response to a status broadcast about low back pain. We coded 31% of responses as expressing sympathy;

“Ouch! Hope you get well soon!”

Offering a shared experience with the second most common response (17%);

“Been there done that”

A small number of responses expressed empathy (4%);

“Take care of yourself. I know back pain is too painful.”

Another main finding was that there were no public responses to more than three quarters (76%) of the status broadcasts.

In summary, our results suggest that people with low back pain use social media to find validation for their experience. This insight into how people interact independently of health care professionals could be critical in informing a patient-centred approach to managing low back pain. We also found that people seem to use social media to obtain sympathy and peer support. Perhaps social media platforms are viewed as valuable spaces to share experiences in a judgement-free environment of peers. Almost 80% of the status broadcasts about low back pain did not receive a public response. One possible reason for this is that people do not feel they have the adequate language or the communication skills to respond to an emotional cry to validate a poorly understood condition.

This study provides a unique insight beyond a clinical interview. Posts to social media about low back pain are most commonly seeking validation. Where they are responses, the responses typically sympathy, but often people do not respond at all.

You can read the full article here.

Thank you Edel O’Hagan (@EdelOH).

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