The dynamics of chronic joint pain: a focus group study

Introduction. Joint pain is a major cause of disability and is an indication for surgery. This study examined the pain experience and coping strategies of people with chronic hip or knee pain. Methods. The study used qualitative methods to elicit the experiences of people with joint pain. Participants were 14 men and 14 women aged 57-89, all of whom had hip or knee pain. Six focus groups were stratified according to pain site and severity. Focus groups used structured discussion about joint pain, and were audiorecorded and transcribed. Data were analysed by identifying codes that emerged inductively; material relating to the codes were grouped and compared with one another. Results. Four key categories were identified: 1) pain is intermittent and variable; 2) pain elsewhere in the body influences the experience of joint pain; 3) pain is inextricable from function; 4) adaptation and avoidance strategies modify the experience of pain. The four categories were dynamically interrelated. The intermittent and variable nature of pain and the presence of pain elsewhere made joint pain unpredictable. However, because participants were aware that function was connected to pain, they were able adapt their activities and thereby reduce the amount of pain that they lived with. Conclusion. Coping with joint pain is based on the experience of its multifaceted and dynamic nature. This is important for the design of studies and of acceptable interventions.