Abstract
Introduction Many New Zealand rural workers have repeated low back pain (LBP) episodes yet continue to work. We wanted to find out why, given that other manual workers with LBP often end up on long term sick leave or permanently disabled. Methods Our primarily qualitative approach used mixed methods to investigate rural workers with non-specific LBP. Participants (n = 33) were surveyed for demographic data, the Brief Illness Perception Questionnaire and the General Self Efficacy Scale followed by one-to-one semi-structured interviews. Analysis ranged from descriptive content to detailed qualitative Interpretative Phenomenological Analysis. Results Participants had high self efficacy scores, positive perceptions about LBP but strong beliefs that LBP is lifelong. Four distinct themes emerged. "Thinking with my head before my back'' and "Knowing the risks'' described participants' innovation regarding job modifications. "Just carry on'' and "Love of the land'' related to stoical resilience and commitment to something more than employment. Conclusions This rural workforce adopts a 'can do' attitude to work, managing LBP within the context of having job control and flexible work practices. Implications: Rehabilitation interventions promoting job control and targeting positive attitudes towards getting on with work, whilst accepting LBP as part of everyday life, may have merit for other workers with LBP.