SIB # 397-Back Beliefs

The Study:  Back beliefs in patients with low back pain: a primary care cohort study.  

The Facts:

a. The authors used the “Back Belief Questionnaire” to measure the beliefs of patients regarding the “negative consequences of back pain”.

b. They looked at 2295 patients with low back pain who had sought chiropractic care.

c. The questionnaire, “consists of 14 statements regarding perceived inevitable negative consequences of an episode of LBP with five of these acting as distractors.”

d. The questionnaire was administered at the patient’s initial evaluation and then 3 months later and finally 12 months following the first visit.

e. The authors note that there is evidence to support the thought that “negative back beliefs are related to LBP and disability”.

f. However, high quality studies in clinical populations are lacking in this area of interest.

g. The authors found that in general these chiropractic patients tended to have “positive back pain beliefs.”

h. Patients who exhibited negative back pain beliefs tended to be those “with disabling LBP, a long history of LBP, and many previous health care visits.”

i. The authors stated, “Importantly, clinicians should be aware that many patients have overly negative expectations about the prognosis of LBP.”

Take Home: Generally these chiropractic patients tended to have positive back pain beliefs but there were those with negative beliefs, primarily those who had suffered longer and more severe histories of pain and had received more treatment.

Reviewer's Comments: While it is gratifying to hear that patients generally held positive beliefs regarding their back pain, it is also very understandable why those with problems of greater severity or duration would tend be more negative. The article is interesting in that it provides some clues as to how we might need to manage chronic pain patients differently.

Reviewer:  Roger Coleman DC

Reference: Gron S, Jensen RK, Jensen TS, Kongsted A. Back beliefs in patients with low back pain: a primary care cohort study. BMC Musculoskelet Disord  2019 Dec 1;20(1):578. doi: 10.1186/s12891-019-2925-1.

Editor: Mark R. Payne DC

Link to Abstract: https://www.ncbi.nlm.nih.gov/pubmed/31787086

Link to Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886198/pdf/12891_2019_Article_2925.pdf