Abstract
BackgroundAlthough previous studies have investigated beliefs about back pain in clinical and employed populations, there is a paucity of data examining the beliefs of the broader community. We aimed to characterize the beliefs that community-dwelling women have about back pain and its consequences, and to determine whether those with varying levels of pain intensity and disability differ in their beliefs.Methods542 community-dwelling women, aged 24 to 80 years, were recruited from a research database. Participants completed a self-administered questionnaire that included detailed demographic information, the Chronic Pain Grade Questionnaire (CPG) and the Back Beliefs Questionnaire (BBQ). The CPG examined individuals' levels of pain intensity and disability, and the BBQ investigated their beliefs about back pain and its consequences.Results506 (93.4%) women returned the study questionnaire. The mean (SD) BBQ score for the cohort was 30.7 (6.0), indicating generally positive beliefs about back pain. However, those women with high intensity pain and high level disability had a mean (SD) score of 28.5 (5.7) and 24.8 (5.7) respectively, which reflects greater negativity about back pain and its consequences. There was an association between negative beliefs and high pain intensity (OR = 0.94 (95% CI: 0.90, 0.99), p = 0.01) and high level disability (OR = 0.93 (95% CI: 0.89, 0.97), p = 0.001), after adjusting for confounders.ConclusionThis study highlights that although women living in the community were generally positive about back pain, subgroups of women with high pain intensity and high level disability were identified who had more pessimistic views. While a causal relationship cannot be inferred from these cross-sectional data, the results suggest that negative beliefs individuals have about back pain may be predictive of chronic, disabling spinal pain.
Highlights
Previous studies have investigated beliefs about back pain in clinical and employed populations, there is a paucity of data examining the beliefs of the broader community
While the high pain intensity group had the greatest proportion of negative responses for 3 of the statements, more women in the group with no pain responded negatively to 2 statements; 'back trouble makes everything in life worse' and 'back trouble means long periods of time off from work'
There was a statistically significant, but not strong, association between beliefs about back pain and levels of selfreported disability, after adjusting for confounders, with more negative beliefs being associated with high levels of disability (OR = 0.93, p = 0.001) (Table 5)
Summary
Previous studies have investigated beliefs about back pain in clinical and employed populations, there is a paucity of data examining the beliefs of the broader community. Chronic low back pain is an economic and social burden world-wide [1]. While most people will experience low back pain during their lifetime [2], much of the suffering and financial costs are associated with the 5–10% of people that experience associated disability [3]. The need to identify factors associated with disabling low back pain so that targeted prevention strategies for primary health care can be developed. Biological, psychological and social factors have been recognised as having a significant impact on the persistence of pain and the development of disability [4]. Irrational beliefs about back pain, in which the pain is considered to be a signal of impending threat, can result in fear of movement/(re)injury, reduced function and activity, and subsequently maintenance and exacerbation of chronic disability [5]
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