Patients' experiences with musculoskeletal spinal pain: a qualitative systematic review.

PURPOSE: Musculoskeletal (MSK) spinal pain, including low back pain (LBP), neck pain (NP), and thoracic pain (TP) imposes substantial global health, social, and economic burden. While quantitative research has explored the clinical aspects of spinal pain, patients’ qualitative experiences remain under-represented. This systematic review aimed to synthesize qualitative evidence on the lived experiences of patients with MSK spinal pain. METHODS: We conducted a systematic search on January 26, 2025, of Medline, CINAHL, Scopus, Web of Science, and EMBASE databases, along with grey literature sources, to identify qualitative studies on MSK spinal pain. The protocol was registered in PROSPERO and published. Eligibility criteria included qualitative studies exploring adult patients’ lived experiences with MSK spinal pain. Two independent reviewers performed eligibility screening, data extraction, and quality assessment using the Joanna Briggs Institute (JBI) qualitative quality assessment tool. Findings were synthesized using a meta-aggregation approach, and GRADE-CERQual was applied to assess confidence in each synthesized finding. RESULTS: Of the 50 included studies, 43 investigated LBP, seven NP, and none investigated TP highlighting a significant research gap. Five major findings emerged on patients’ experiences living with MSK spinal pain: (1) the persistent uncertainty and overwhelming nature of spinal pain and its impact on daily life (moderate confidence); (2) navigating the complex healthcare system while seeking relief from spinal pain (moderate confidence); (3) the emotional and social toll of living with spinal pain (high confidence); (4) adapting to and building resilience against the challenges of spinal pain (high confidence); and (5) the impact of deep-seated beliefs on the understanding and management of spinal pain (moderate confidence). While these findings were broadly consistent across both conditions, some region-specific differences were observed. For instance, mobility limitations were more prominent in LBP, whereas headaches and upper body functional impacts were noted in NP. CONCLUSION: Patients with MSK spinal pain face a range of interconnected physical, emotional, social, belief and healthcare driven challenges. Our findings suggest that patient-centered care should address both physical symptoms and the broader psychological and social impacts of spinal pain. The lack of thoracic pain studies underscores a critical area for future research.