Public Release:  Attitudes, beliefs and health literacy impact how patients manage chronic lower-back pain

According to a new study published in Pain

Elsevier Health Sciences






High-disability (HD) and low-disability (LD) groups were compared. The HD group reported a greater degree of interference with recreational activities (86%) compared to the LD group (27%). The HD group also reported significantly greater fear avoidance beliefs about physical activity, adopted a more passive coping style and was less optimistic about the future progression of their condition. While all participants with CLBP had adequate health literacy scores measured on a questionnaire (S-TOFHLA), qualitative (interview) data highlighted difficulties in seeking, understanding and utilizing LBP information.

Individuals in both the HD and LD groups identified similar perceived causes for LBP, including sports injuries, incorrect manual handling procedures, and poor posture. Individuals with CLBP-low disability also cited their work practices, in particular sitting at a computer for too long, general "wear and tear," and heritability as causes of their disability, while individuals with CLBP-high disability cited being overweight and ageing as causes for their LBP.


An important finding from this study was that individuals with CLBP-high disability tended to attribute their pain experience to an anatomic reason, while this trend was not noticed in the CLBP-low disability group. "Although anatomic reasons may be important in some cases of CLBP, international data and guidelines highlight the importance of psychological and social factors in the etiology of CLBP," commented Dr. Briggs. "The fact that individuals with CLBP-high disability believed anatomic factors were the primary reason for their pain experience highlights that belief systems and information provided to patients are critically important in management."


The article is "Health literacy and beliefs among a community cohort with and without chronic low back pain" by Andrew M Briggs, Joanne E Jordan, Rachelle Buchbinder, Angus F Burnett, Peter B O'Sullivan, Jason Y.Y Chua, Richard H Osborne, and Leon M Straker. It appears in Pain, Volume 150, Issue 2 (August 2010) published by Elsevier. DOI: 10.1016/j.pain.2010.04.031
