Beliefs about back pain affects prognosis


Low back pain is widely prevalent worldwide and can have profound effects on people's health and way of life. There is also a considerable financial burden associated with the treatment of low back pain, and costs the NHS over 1 billion pounds each year in the UK.


A very important part of helping those who suffer low back pain is education. Helping patients understand their back pain empowers them to manage and believe they will recover, and be able to continue their lives as normal. The basis on which these negative beliefs are constructed is also important to identify so their thought processes can be modified to encourage a more positive outlook. It has been documented that fear avoidance beliefs and low recovery expectations are independently associated with poor outcomes, including delayed return to work, activity limitation and pain persistence.


A study assessed the beliefs and attitudes 1000 participants towards low back pain. They were assessed using a back pain questionnaire form. There was a high response for the need to protect the back to avoid injury, as well as there being a special nature of back pain. Many of the participants were uncertain about how pain related to injury. It was encouraging to observe that many held positive beliefs about continuing to remain active during an episode of back pain, but the level of safe exercise was uncertain. Those who were currently experiencing back pain had more negative views about prognosis.


The majority of back pain cases will resolve within six weeks, but when patients are unsure of the cause, prognosis and what they can do to help, this can all feed into a negative cycle, which may prolong their back pain and start to build irrational beliefs that affect their normal daily lives.