Table 3.

Example quotes from participant interviews

Theme	Example Quotes from Participant Interviews
1. Physical Effects	Symptoms of Pain, Discomfort: “It’s the pain in my leg and also there is times that when I have to go to the washroom; excuse me; that I have to sit. It’s my knees; like sometimes I can hardly sit down on the toilet and sometimes it’s hard for me to get up. Let’s say, if I sit down on the chair, I’m fine, but then when I have to stand up, I cannot stand up or when I start walking, it’s hard to walk. When I feel better it’s when I’m lying down or sitting down, but then when I’m sitting down and then stand up and starting walking that’s the worse part.” “A burning feeling say from the top of the leg to the knee. A feeling that there was something crawling, as if they were bugs just underneath the surface of the skin crawling up and down and you know, it was pretty disconcerting.” “Like I said it started in 2010 and I had often a lot of back pain, lower back pain. It went down into my left leg, but it was also accompanied by numbness in both legs, so severe at times that I would lose the feeling in both my legs and I would fall and go down.” “Not being able to walk as far as I would like to without having to stop and experience the tingling in the front of my leg and the numbness in my foot and the pain associated with it.” “When I first started the clinic here, I could not walk for than a minute and a half and I had to stop. My legs would swell. My feet would hurt that the sciatic nerve in my back would almost pull me down that it would cripple me. Even to walk, I work at [Name of Location] and to walk here I got to stop 6 or 7 times and this is me, I’m use... to running that distance.” “It started I suspect 5 years ago, as a minor back pain. One usually would think it is just a strain, but over the years it has gradually progressed to the point where now it is very debilitating.” “Now I’ve had that for very many years, but it’s always been bearable. The stenosis has really affected my daily life and it makes me sad at times, such I have to contend with it. At the same time, I must honestly admit that I am grateful for the health I’ve had. I realized that I have been very lucky. So, I can’t have it always, but at the same time its human nature to resent it that I get such pain all the time.”
2. Activity Effects	Limitations on Walking/Standing/Sitting: So I really, I can walk may be 4 or 5 minutes. It’s really tough on my lifestyle. I used to love to walk. Me and my wife used to walk for miles... and now I cannot walk a block.” “Like I say everything depends on my legs because I walk and I’m one of them simple people; I don’t do anything. I don’t travel. I have no interest in that.” “Well it affected my ability to get around and walk... It affected my exercising, which is walking. I do quite a bit of walking for exercising and I just love to walk. I get out and I walk all over the place... Now, I go around in the car... I take the dog. Instead of walking about three blocks to take my dog out to run, I take the car there to let her run.” Limitations on Recreational Activities: “Usually each weekend in the summer I’m outside... in the canoe or with backpack you know, but now I am sitting at home.” “When it first started what it did curve is my physical activities such as curling and walking long distances and so on, and eventually it curved all activities that even stairs were very difficult to manage.” “...we were in a wedding and I was dancing. It was a slow dance and it seemed that my legs were giving up on me. I was shocked and I didn’t know what was happening. I had to go and sit down.” “Because I wasn’t able to, say, walk any distance, so that pretty well inhibited, so you were sort of left with sedentary hobbies like reading and crocheting that sort of thing because you’ve found that you’ve gravitated towards that than avoiding the physical.” Limitations on Social and Household/Daily Activities: “It changed my lifestyle because you know, as I said before I was very cheerful. I like friends. I like being among people. I am [a] social person. I’m a socializing person and all this pain and weakness, like, it stopped me from being among people.” “One of the major and also major things that really bothered me a lot; my granddaughter had a child, two and half years ago and also I’m crazy about babies. I found that profoundly sad that I couldn’t hold the baby. I cannot even lift him of course...I cannot lift him.” “Well, it affected me to the point where I couldn’t go walking with my wife for more than a block and a half and standing around talking or when we go to parties, I would stand talking then I would have to sit down because I just couldn’t stand up anymore after a while. “ “Well, I love to garden. I kind of filled in my flower beds with rocks because that’s just another thing I can’t do.” “I couldn’t do my usual home activities like cooking. I depended on my husband to assist me with the cooking and housework and things like that.” “Eventually it got to the point where I couldn’t even rinse off three cups, three bowls, and put them into the dishwasher. I couldn’t stand up long enough with that pain.” “Or go shopping, I used to go by myself for the shopping and now I got to go with my husband or my son because I realized that I cannot take shopping bags or heavy things. I used to do my grocery shopping and now I got to go with my husband. Why? Because I cannot lift anything.” “I think on a daily basis is that I cannot shower, dry my hair, and put on my makeup without sitting down and that kind of happened in the last few months. I have to take a break, you know sit down for 5 or 10 minutes. We put a stool in the bathroom, so that I can sit and do my makeup and stuff like that.”
3. Emotional Effects	Depression/Social Isolation: “Really, it’s a miserable life, miserable. I don’t wish this to no one... The worst thing is... how people see you in the outside; your face, they think you’re not sick; you’re not suffering, but inside you are suffering. I have a life, but it’s not life because you cannot do what you want to do... I was a very active woman and which right now I feel inside of me, I feel 90 years old. I feel terrible, like inside because I want to do things with eyes and with my mind, but then when I start doing things it stops me from doing them.” “My life is not the best, you know. Sometimes if I want to go out or let’s say go to parties or if I am invited to parties, sometimes I avoid it. I don’t feel like do nothing. I rather stay home and do whatever I can.” “I can’t take part in my church activities in the same way that I did. I tend to give money instead of labour and I know you have to give what you can, but that’s all I can give, but it grieves me. I rather be in there with all the other women doing things. It upsets me very much.” “Well, I have hard times walking and I feel a little out of place when I can’t go that fast anymore. I have to stop or I have to sit down or I have to do something like that. It sort of puts me in a different area than the friends that I’m with who can do all this stuff.” Anxiety: “Well, I guess there is an underlying stress all the time that you know, I’m waiting for an operation and it may not be and it’s probably not going to be 100% successful, so it is a gradual accommodation to the fact that this is who I am now.” “Well, it’s yes, but not that fine. Before it was the walking, I felt like I was going to be kind of paraplegic that I wouldn’t be able to do things myself and I would have to sit in one of those electronic chair things.” Frustration: “The first time I had it I thought it was a condition that I was fighting that I would get rid of it, which I did and it would go away, but it has been there all the time. The lack of information I had at that time was, I would get free of this, but eventually I knew that I got this for life. This is something you inherit for life. It is threatening and it is very debilitating.” “You had to this, this and this and I thought quite naively that if I did the regimen while I was taking physiotherapy then when we were finish we were finish and that was good... I would be cured. I did not realize that this was an ongoing thing that just got worse when I stopped doing it.” Hurt Pride “It affects in so many ways, it’s the whole quality of life, the whole thing. Your wife is dependent on you, your kids and grandkids are dependent on you for doing these things. Now all of a sudden this person who used to run with me and play with me and can’t even walk down the end of the street with me and it takes a lot of your pride, well at least me it takes a lot of my pride. Even to think of someone having to take care of me, to me it’s just unacceptable.” “I walk kind of awkwardly. I cannot wear heel shoes either, but that really does not bother me that much. All my days of heel shoes are really behind me, so that would be in anyway an older woman wouldn’t be wearing fancy shoe anymore. I am the same as the other old ladies. You know it is awful giving up your autonomy and moving into a different phase. This is one of the reasons why I lie about my age all the time. People tend to put you in category of nature. If you are a certain age, you are just kind of put aside.”
4. Coping Strategies	Coping Mechanisms for Physical Effects: “I have to... generally stand a few seconds or so before my husband is ready, maybe while he is doing the cheque... I stand right there waiting for him because if I get up there is no way I can start walking again because of the pain in my thighs. The front of my thighs is screamingly painful. I just stand for a minute or two and get my act together... I do walk strangely to begin with when I’ve been sitting down.” “My condition, you know the pain in my legs increased. I get tingling in my legs, sometimes pain, but I learned not to take painkillers. I don’t take nothing. When I get like this, I just lay down, I rest for a bit and after rest I feel a little bit better.”
5. Treatment Effects	Partial Relief from treatments: “It just involves may be 2 hours a day of specific exercise and walking and if you don’t do it, you know you can’t miss 2 days in a row because your symptoms all come back.” “...now having done the physiotherapy it’s been a miracle. It is just wonderful. It’s so much better. It will never go away, but at least I can do things that can help the pain and you know alleviate the different symptoms that occur.” “They helped, but it’s not like they changed my life, either.” Complete Relief from Treatments: “I don’t have this excruciating pain. I can walk up the stairs. I can run up the stairs. I can run down the stairs... since I had the surgery, this surgery, I have improved considerably and I am almost back to normal like a normal person.”
6. Expectations from Treatment	Pain Relief/Decreased Pain “I try to keep an open mind that the treatment will alleviate the pain. If that happens, so much the better, but I am not counting on it to eliminate the pain. I will continue with the process and do the exercises and just hope for the best, but I haven’t set a high level of expectations that this is going to cure me.” “I would like to think in doing the treatment that the pain level will be not necessarily gone, but certainly tolerable and not be something that I thought would stop me from doing what I wanted to do.” Pain Elimination “Based on my own experience, I would expect it to eliminate the problem. It did the first time and I would assume that it would the second time.” “Well, I would say significantly. It wouldn’t make much sense to have an operation if it was not going to have much effect on the pain [in reference to surgery].” Increased Physical Activity “That I can walk better. Walk with more distance and that I can stand on my own feet and do at least my housework. Taking care of my family properly. Instead of being in pain, when I’m standing or walking I’m in pain, but pain goes away. To relieve me from pain and suffering.” “Run around with the grandkids a little bit maybe, you know, maybe be able to do some things and not feel like I have to stop because of the pain in my leg” “...consciously plan my route when I wanted to do an activity that I wouldn’t have to very, very specifically, what is it that I need to do to accomplish today and how am I going to do it and not have my back stop me from doing it” “Just to be able to stand around more without the pain and be able to walk farther without stopping because of the pain in my leg.”