Background: Chronic widespread pain (CWP) is a major burden to both the person and the community. Non-tumor chronic pain is one of the most common causes for long-term sickness absence in Sweden. The prevalence of CWP in the general population is approximately 10%, and the condition is almost twice as prevalent in women, than in men. Increased understanding of how women with CWP describe triggering factors of pain and pain progress would be of importance when preventing poor pain prognosis, and when customizing the treatment strategy in a setting with person-centered care.

Objectives: To explore experiences of factors influencing the progress and severity of pain among women who have developed CWP within the last 21 years.

Methods: This is a descriptive study, using a qualitative content analysis with an abductive approach ¹ . Nineteen women reporting CWP in a survey 2016, between 45-67 (median 57) years of age, who had not reported CWP in a survey 1995, participated in the study. Data were collected through individual interviews with open-ended questions: “Can you describe how your CWP has developed the last 20 years?”, “How did your CWP change over time?” and “Have you experienced any important events that have influenced the development of your CWP?” Data were analyzed through a manifest qualitative content analysis and six categories emerged.

Results: The women described their journey to CWP in terms of triggering, aggravating and consolidating factors. Six different categories emerged; physical strain, emotional strain, social strain, work-related strain, biological strain and environmental strain. Physical strain included strenuous physical activities in leisure time, having muscle tension, inactivity or sleeping problems. Emotional strain included being depressed, worried and stressed, as well as neglecting the pain. Social strain included to prioritize other people before oneself and to meet distrust from the social surroundings. Work-related strain included heavy, monotonous and stressful work but also sedentary work. Biological strain referred to heredity, age and infections. Environmental strain meant that the climate or weather aggravated the pain.

Conclusion: The women in the study described how their journey to CWP was influenced by both external and internal strains. The six categories representing different types of strains were recurrent in a context describing triggering, aggravating and consolidating factors. This highlights the complexity of individual pain progress and argues for the importance of person-centred care approaches and rehabilitation programs. The fact that women with CWP feel mistrust from healthcare professionals indicates that the current care approach needs to be changed.