Discussion
’, orthosis, pain
RECURRENCE
To our knowledge, this is the first qualitative study exploring the lived experience of people with LET. We identified four themes related to the experience of patients with LET: (1) known cause of onset, (2) impact on everyday life, (3) self-help and understanding of the condition and (4) the healthcare experience.In line with previous evidence, many participants reported knowing what they felt had caused the onset of their symptoms, such as a sudden change of activity or repetitive use.The study findings suggest that people with LET frequently experience a substantial impact on basic functional tasks and hobbies although most were able to continue to work regardless of the pain. It has previously been estimated that up to 5% of working-age adults with LET take time off work.Participants reported feeling reluctant to seek self-help advice until they had received a diagnosis for their symptoms from a healthcare professional, for fear of doing self-administered treatment that may ‘aggravate’ their symptoms. During the OPTimisE intervention design, condition-specific and general health advice and education, including basic pain science, delivered by a physiotherapist and supported by printed and online resources, was selected as one of the three key treatment elements.Many participants perceived that they had received healthcare treatments that were ineffectual and, in one instance, harmful. The National Institute for Health and Care Excellence’s clinical knowledge summary advises initial management of activity modification, consideration of an orthosis and paracetamol or topical NSAID gel. If symptoms persist beyond 6 weeks, physiotherapy is recommended and oral NSAIDs can be considered if topical NSAIDs have failed to provide relief. It advises against routinely offering corticosteroid injections due to limited long-term effectiveness and high rate of symptom recurrence.Strengths of this study are that this is the first qualitative study exploring the impact of LET on patients’ everyday life and included individuals from a range of socioeconomic and ethnic backgrounds. We acknowledge though that qualitative studies draw on the opinions of those interviewed and may not be truly representative of the wider population; however, our aim was in-depth exploration of these views. The opinions presented are from people accessing healthcare for LET and so may not reflect the views of those who do not access healthcare for LET, due to lower symptom severity, stoicism or inaccessibility. This may exclude some underserved groups.