Patients’ experiences with musculoskeletal spinal pain: A qualitative systematic review protocol

PLOS ONE STUDY PROTOCOL Patients’ experiences with musculoskeletal spinal pain: A qualitative systematic review protocol Alaa El Chamaa ID*, Katie Kowalski ID, Pulak Parikh, Alison Rushton ID Faculty of Health Sciences, Western University, London, Ontario, Canada * a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 Abstract Background OPEN ACCESS Citation: El Chamaa A, Kowalski K, Parikh P, Rushton A (2024) Patients’ experiences with musculoskeletal spinal pain: A qualitative systematic review protocol. PLoS ONE 19(8): e0306993. https://doi.org/10.1371/journal. pone.0306993 Editor: Adedayo Ajidahun, University of the Witwatersrand Johannesburg, SOUTH AFRICA Received: February 28, 2024 Musculoskeletal (MSK) spinal pain encapsulates various conditions including lumbar (low back), cervical (neck), and thoracic pain that significantly impact individual and global health. While clinical aspects of spinal pain have been well-studied, understanding patients’ personal narratives and lived experiences remains essential for enhancing patient-centered care, improving treatment adherence, and informing healthcare policies. It provides deep insights into the impacts of spinal pain, guiding more effective and empathetic treatment approaches. This systematic review aims to synthesize qualitative evidence on patients’ experiences with MSK spinal pain, providing insight into the challenges faced, coping strategies, daily life impacts, and healthcare interactions. The objective of this review is to synthesize the qualitative evidence regarding the lived experiences of patients with MSK spinal pain. Accepted: June 25, 2024 Published: August 8, 2024 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0306993 Copyright: © 2024 El Chamaa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion. Methods This systematic review will use a meta-aggregation approach to synthesize data from qualitative studies, that will be identified through a comprehensive search of electronic databases and supplemented by grey literature searches. Two independent reviewers will screen, identify, and extract data from eligible studies. In cases of disagreement, conflicts will be resolved by consulting a third reviewer. These same reviewers will then use the Joanna Briggs Institute (JBI) qualitative quality assessment tool to evaluate the methodological quality of the identified studies, with the derived scores informing the synthesis process, that will involve extracting each study’s findings along with their supporting illustrations, then grouped into categories based on similarity in meaning. These categories will then be aggregated to form synthesized findings. Implications Synthesized findings on patients’ lived experiences with MSK spinal pain including key themes, patterns, and insights will be presented. By emphasizing patient narratives, the PLOS ONE | https://doi.org/10.1371/journal.pone.0306993 August 8, 2024 1 / 12 PLOS ONE Funding: The author(s) received no specific funding for this work. Experiences with musculoskeletal spinal pain results of the review can contribute to the optimization of outcomes, and to enhance patientprovider relations and improve quality of care in MSK spinal health. Competing interests: The authors have declared that no competing interests exist. Introduction Musculoskeletal (MSK) spinal pain encapsulates various conditions including lumbar pain (low back pain (LBP)), cervical (neck) pain, and thoracic pain; significantly impacting global health. Low back pain is the most common, with a prevalence of 619 million people affected worldwide in 2020, and projections suggest an increase to 843 million by 2050 [1]. LBP is not only prevalent [2–5], but is also a leading cause of disability, imposing substantial economic and healthcare burdens [6–8]. According to a preprint article, neck pain is also a very common health condition with a prevalence of 203 million people affected in 2020, projected to rise to 269 million by 2050 [9]. Neck pain ranks among the top contributors to global disability, also leading to substantial economic burdens [10, 11].Thoracic pain, while less prevalent than LBP and neck pain, poses a significant challenge to those affected. Though not as widespread, thoracic pain contributes notably to disability, and incurs considerable economic burdens comparable to those of more common spinal pain conditions [12, 13]. It is less researched, and often overlooked [13]. Beyond the clinical and physiological exploration, there is a rich tapestry of personal narratives of experiences, emotions, and beliefs that people with MSK spinal pain present with daily. While there is a substantial body of quantitative research focusing on the clinical and epidemiological aspects of spinal pain, qualitative investigations exploring the lived experiences of patients are comparatively scarce. After decades of researching and studying the spine, only 38 unique qualitative studies addressing patients’ experiences with spinal pain (neck and LBP) were included in previous systematic reviews [14–16]. This gap indicates a significant underrepresentation of patient-centered perspectives in the existing literature, highlighting the need for more qualitative research. The significance of understanding patients’ experiences with spinal pain cannot be understated. Currently, patients “struggle to be seen and understood as a person”, and they have "a desire to be taken care of and listened to" [17]. Understanding their experiences can help shed light on patients’ daily challenges, their coping strategies, and can influence healthcare interactions, compliance with treatments, and the overall quality of life [18]. Insights into the lived experience of people with MSK spinal pain can guide healthcare providers in tailoring patient centered care which will optimize treatment outcomes and enhance patient-provider relations [18]. Qualitative research is the research method that can “make the world visible” “attempting to make sense of, or to interpret, phenomena in terms of the meanings people bring to them” [19]. Qualitative research enables exploration of the narratives and phenomenological experiences of patients with MSK spinal pain. A systematic review can collate, evaluate and synthesize qualitative findings on a broader scale, providing an understandi (...truncated)