The experiences of systemic invalidation in chronic pain care among socioeconomically disadvantaged individuals: An interpretative phenomenological study

This study explored the lived experiences of individuals from socioeconomically disadvantaged communities living with chronic pain and prescribed pain-relief medication. Using Interpretative Phenomenological Analysis, eight participants were recruited from a single primary care network in England. Two Group Experiential Themes were developed. This paper reports one: From Dismissed to Disengaged: the trauma of seeking help, with three sub-themes: (1) "Being fobbed off" - dismissal across healthcare and benefit systems; (2) "It just seemed horrible to me, to take it off me" - pain relief as withdrawn, stigmatised, or conditional; and (3) "Do I want to poke the bear?" - disengagement from services. Participants described being dismissed, losing access to medication without prior discussion, and avoiding services out of fear or futility. While most reported systemic invalidation, some described collaborative support. Findings highlight the need for trauma-informed, person-centred care that recognises the role of power and inequality in shaping chronic pain.