Dor lombar na população rural: relato de experiência de uma residente do programa de medicina de família e comunidade

Abstract

Introduction/Justification: Low back pain is considered a public health problem, causing a significant portion of work absenteeism. Its risk factors include female gender, age, and performing repetitive strain activities. This type of work is very common in rural areas, where the peculiarities of health care can also interfere with the care process (MALTA, 2022). Objectives: To report the experience of being part of a Family Health Team in a rural setting, mainly aiming to share the challenges and potential existing in the management of low back pain in rural workers. Materials and Methods: This is a descriptive health study with a qualitative approach, of the experience report type. This production occurred from my experience as a recently graduated doctor, working in the family and community medicine residency program, between 2023 and 2024, in the rural area of the municipality of Caicó-RN, in the interior of northeastern Brazil. During this period, approximately 960 patients with complaints of low back pain were treated, and from this, it was possible to reflect and consider this symptom and the particularities of its care in rural settings, including the challenges and potential of public health. Results and Discussion: For approximately two years, I was part of a rural family health team, where I was able to experience the particularities of health care. There were many challenges encountered: long distances traveled, little human and structural support, and different disease profiles compared to urban settings. Among the most common complaints in the office, low back pain was present from the beginning. In addition to all the universal risk factors, in my local reality I encountered other particularities and barriers to managing this symptom. In practice, it was difficult to refer patients for additional care, whether it was exams or consultations with physiotherapists and other specialists. And this directly reflected in the patients' outcomes, especially in the most severe cases. Since low back pain management must be multidisciplinary, medication-only treatment resulted in temporary improvement, chronic use of analgesics, and frequent relapses. Final considerations: It is discouraging to see a patient not improving due to issues that go beyond their professional practice and domain. However, this difficulty led to professional development, as it allowed me to learn about therapeutic alternatives that could be put into practice in rural settings, in addition to encouraging me to talk to the team and management in search of solutions.