“Being away from everything”: Exploring the importance of access to nature for individuals living with chronic low back pain

Chronic low back pain is a persistent and debilitating condition, and therapeutic outcomes in the long term are generally poor. There is growing evidence to support the ineffectiveness of 'one-size-fits-all' pharmacological approaches to pain management. To that end, alternative non-pharmacological therapies such as green social prescribing and time spent in nature are gaining popularity. But it is imperative to understand to what extent these potential interventions are viable by gaining a deeper insight into the lived experiences of the chronic low back pain community. The present qualitative cross-sectional study employed ten semi-structured interviews (9 women, M age = 50.1, M years w/cLBP = 19.1) to explore individuals' coping strategies in living with chronic low back pain, and to what degree nature spaces ameliorate pain. Two themes, both with four subthemes respectively, were derived from Reflexive Thematic Analysis; (1) Importance of Nature, and (2) Inaccessible Nature. The present study highlights the importance and meaning of access to nature spaces for individuals with chronic low back pain, but also how difficult and exclusionary those spaces can be, especially for groups with physical disabilities. Future research can build upon the findings here to develop therapeutic interventions for patients living with chronic low back pain to aid accessibility to nature spaces by either implementing real-world adaptations to improve accessibility or develop interventions which help bring nature closer or indoors. PERSPECTIVE: This study explores the lived experiences of individuals with chronic low back pain, emphasising the importance of access to nature in coping with chronic low back pain, whilst addressing accessibility challenges.