An exploration of experiences and beliefs about low back pain with Arab Muslim patients

Dana Maki*, Heidi Lempp, Duncan Critchley

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Purpose: Pain has psychological, social, physical and spiritual dimensions and therefore this experience is influenced by culture. The aim of this study was to explore the experiences and beliefs of Arab Muslim patients with low back pain (LBP) in Bahrain. Methods: We recruited Arab Muslim patients attending physiotherapy with LBP ≥3 months, and ≥18 years of age. Socio-demographic information and a Visual Analogue Scale (VAS) score for pain intensity were collected. Focus groups were conducted between 2013–2014, using pre-determined semi-structured interview questions. Qualitative content analysis was applied with single counting and inclusion of negative instances. Results: 18 participants attended three focus groups (14 females and 4 males) with a mean VAS(SD) = 5.28(±1.97). Five themes were identified; (1) loss of independence, (2)change in identity causes distress, (3) beliefs and attitudes towards low back pain, (4)trying to cope with LBP, and (5)experiences within the healthcare system. Conclusions: Religious and cultural beliefs influenced pain-related beliefs, fear-avoidance beliefs and catastrophizing. We recommend addressing cultural gender roles and using “active” forms of religious coping to inform treatment. Participants’ experiences within and experiences of the healthcare system were similar to Western cultures. This encourages the application of Western findings into practice to facilitate the management of these patients.IMPLICATIONS FOR REHABILITATION A qualitative exploration was undertaken to explore the experiences of Muslim and/or Arab patients with LBP. Our findings show that females have prioritised family needs over their own, primarily due to perceived gender roles. Contrary to previous findings labelling religious coping as a passive strategy, our findings suggest that religious coping strategies can be both positive and active strategies; such as participation in religious occasions and frequenting mosques. We support recommendations from Western literature to manage LBP; such as prioritising patient education and joint decision-making.

Original languageEnglish
JournalDisability and Rehabilitation
Publication statusAccepted/In press - 2021


  • Arabic
  • cultural competency
  • culture
  • low back pain
  • pain beliefs
  • pain coping mechanisms


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