Abstract
Low back pain remains a major health problem with huge societal cost. Biomedical models fail to explain the disability seen in response to reported back pain and therefore patients’ beliefs, cognitions and related behaviours have become a focus for both research and practice. This study used the Pain Beliefs Questionnaire and had two aims: To examine the extent to which pain beliefs are related to disability, anxiety and depression; and to assess whether those relationships are mediated by pain self-efficacy and locus of control. In a sample of 341 chronic low back pain patients, organic and psychological pain beliefs were related to disability, anxiety and depression. However, organic pain beliefs were more strongly related to disability and depression than psychological pain beliefs. Regression analyses revealed that these relationships were in part independent of pain self-efficacy and locus of control. Further, mediation analyses revealed indirect pathways involving self-efficacy and, to a lesser extent chance locus of control, between organic pain beliefs, on the one hand, and disability, anxiety and depression, on the other. In contrast, psychological pain beliefs were only directly related to disability, anxiety and depression. Although longitudinal data are needed to corroborate our findings, this study illustrates the importance of beliefs about the nature of pain and beliefs in one’s ability to cope with pain in determining both physical and mental health outcomes in chronic low back pain patients.
Highlights
Despite considerable attention, low back pain remains one of medicine’s most enigmatic problems, in its chronic form
This study aims to assess the extent to which pain related physical and mental outcome measures can be explained by individuals’ pain beliefs as measured with the Pain Beliefs Questionnaire (PBQ) [39]
Examination of the mean and standard deviations suggested that participants were similar to previous low back pain samples [46]; see Table 1
Summary
Low back pain remains one of medicine’s most enigmatic problems, in its chronic form. Most low back pain is largely non-specific in nature, but has a societal cost greater than that for cancer, coronary artery disease and AIDS combined [4]. A systematic review by Dagenais, Caro and Haldeman [5] showed inconsistencies in the calculation of costs but found all studies to indicate back pain to be a substantial burden on society. In terms of healthcare costs, a recent study from the UK indicates that costs associated with chronic low back pain sufferers were twice that of matched controls [6]. Key to understanding the psychosocial influence is the consideration of individuals’ beliefs, cognitions and behaviours
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