What if my back breaks? Making sense of musculoskeletal pain among South Asian and African-Caribbean people in the North West of England

Objectives The pain and disability, which arise as a result of musculoskeletal conditions, have been central to theories and understanding about chronic illness. However, little attention has been paid to the experience of such pain amongst ethnic minority groups. In this paper, we explore Asian and African-Caribbean respondents' ideas about the nature of and management of widespread pain. Methods Our data are drawn from a qualitative study linked to an epidemiological study of musculoskeletal symptoms undertaken in the North West of England. In-depth interviews were carried out with 32 people. Themes identified from the data were causes of symptoms, experience of pain, primary care utilisation and self-management. Results For both African-Caribbean and South Asian populations widespread pain was reported more frequently than a general population sample residing in the same locality. However, notions of the experience and management of widespread pain differed. Accounts of pain from the African-Caribbean respondents coincided with a traditional Western medical model of psychogenic pain and individualised coping strategies. Descriptions from some South Asian respondents suggested a lack of demarcation between pain located in specific parts of the body and broader social and personal concerns and an unwillingness to recognise the latter as "depression" or psychological distress. Help from family members was referred to more than individual strategies of managing pain. Conclusions Differences in the experience of musculoskeletal has relevance for understanding the way in which psychosocial distress is manifested and managed in primary care. © 2004 Elsevier Inc. All rights reserved.