Pain beliefs can hold you back

What do people with different kinds of back pain believe about pain and how do these beliefs impact recovery?

Take Home Messages:

Patients with non-specific back pain (i.e. back pain that is not caused by a diagnosed medical problem) are more likely to believe that pain is an indication of damage and that their pain is never going to get better than those with back pain caused by a specific medical problem.

Why the research matters:

Chronic back pain is common. The development of chronic pain and disability following low back injury is affected by the beliefs that patients have about their pain. Studies conducted to date looking at pain beliefs have involved patients with non-specific low back pain.

This study investigates whether pain beliefs may differ between those with specific versus non-specific low back pain so that these beliefs may be appropriately addressed by treating clinicians.

What the research involved:

The study, conducted in the UK, contained 3 groups:

Those with specific back pain (80 participants);
Those with non-specific back pain (80 participants); and
A pain-free group (77 participants).

Participants with low back pain completed questionnaires addressing their beliefs about their pain and its causes, their coping strategies, the presence of disability or pain, and psychological distress. Those in the pain-free group completed a questionnaire about their pain beliefs.

Summary of research findings:

The study found that:

Those with non-specific back pain were more likely to believe that the presence of pain meant the presence of damage than those with specific back pain;
Those who were pain free were the least likely to believe that the presence of pain meant the presence of damage;
Those with non-specific back pain were more likely to believe that the pain was never going to get better than those with specific back pain; and
Those who believed that the presence of pain meant the presence of damage were more likely to also believe that their pain was never going to get better.

Original research:

Beliefs about the causes and consequences of pain in patients with chronic inflammatory or noninflammatory low back pain and in pain-free individuals.

Sloan TJ, Gupta R, Zhang W, Walsh DA.

Spine. 2008 Apr 20;33(9):966-72.

Link to PubMed abstract