Take Home Messages:

Back pain is very common in the community and affects almost everyone at some stage in their life.

The majority of people experience only mild back pain and have positive views about back pain.

A small number of people experience severe back pain and associated disability.

Severe back pain and disability makes people more likely to have pessimistic views of back pain.

Pessimistic views of back pain may be a predictor for ongoing back problems and can prevent people from receiving proper treatment. This information should be provided to people suffering from back pain, in order to assist them manage their problem.

Why the research matters: 

In clinical settings it is possible to adjust people’s attitudes towards pain to improve outcomes, but little is known about back pain experienced by those who are not receiving ongoing medical treatment. This study targeted people in the general community to assess their attitudes towards back pain.

Almost everyone experiences back pain at some stage in their life and 5-10% of the population will develop some sort of disability as a result. Back pain causes a huge economic and social burden. It is one of the most common reasons for missed work days.

Understanding the factors associated with disabling back pain enables the development of targeted prevention programs.

It is known that attitudes towards pain can affect a person’s recovery from back pain. For example, an irrational fear that pain is a sign of further injury can prevent a person from undergoing appropriate physiotherapy programs.

What the research involved:

Rather than targeting people in a clinical setting, where regular contact with health practitioners occurs, the study surveyed about 500 women in the general community and asked about their experiences of back pain. The study was conducted in the Australian state of Victoria.

The aims of this study were to:

• Characterise the beliefs of women about back pain and its consequences; and
• Determine whether individuals with varying levels of pain intensity and disability differ in their beliefs about back pain.

Summary of research findings:

Back pain was common in the women surveyed:

• 90% had experienced back pain at some time in their life
• 75% had experienced back pain in the last 6-12 months
• 22% were experiencing back pain at the time of the survey

Only a small number of women reported severe pain. Similarly, only a small number of people reported a high degree of disability.

The majority of women in the community had positive beliefs about back pain.

If people have ongoing back pain, they are more like to report pessimistic views about back pain.

The women had the following negative beliefs about back pain:

• Half believed that once you have back pain there will always be some sort of weakness.
• One third believed that:
  • Once back pain starts it will cause trouble for the rest of one’s life;
  • Everything is worse with back pain; and
  • Back pain will get worse with old age.
• One fifth believed back pain:
  • Will eventually stop one from working; and
  • Should be rested (current medical practice promotes movement).

Negative views of back pain are a useful indicator that someone may be more likely to suffer from ongoing disabling back pain. (This is not the same as saying that negative views of back pain make you more likely to develop back problems-but rather is information that may be useful to people who manage back problems.)

This information is useful to health care providers and may help to identify those at risk of ongoing disabling back problems.

Original research:

Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women

Urquhart DM, Bell RJ, Cicuttini FM, Cui J, Forbes A, Davis SR.

BMC Musculoskelet Disord. 2008 Nov 4;9:148.

PubMed abstract