Patients' Beliefs About Causes of Low Back Pain
Pain beliefs are linked with pain intensity, psychologic distress, and disability. Having the wrong understanding or belief about the cause of your low back pain (LBP) can be more harmful than the problem causing the LBP.

In this study, researchers compare the pain beliefs of patients' with two different types of LBP. The first group had noninflammatory LBP. This is the most common diagnosis in patients with chronic LBP. The second group had inflammatory LBP called spondylitis. Only 0.2 per cent of the western population has this type of LBP. The study also included a third (control) group of people who were pain free.

What patients believe about their pain dictate how they cope with their pain. For example, many patients with noninflammatory LBP believe that pain means there is ongoing damage occurring in the spine. They start to avoid certain activities or movements out of a mistaken belief that this will prevent further pain.

Another coping strategy is called catastrophizing. This is the belief that the pain will never go away. The patient is powerless to change and has no control over the situation.

Everyone in this study filled out four different surveys assessing their pain beliefs, coping strategies, and levels of catastrophizing. Analysis of the results showed that patients with noninflammatory LBP were more likely to be depressed and to catastrophize their symptoms.

The authors suggest that having a proper understanding of their diagnosis can help patients avoid unhelpful pain beliefs. Pain beliefs are learned and can be changed. Focusing on repair processes rather than damage or degeneration may be a good tool to use during treatment. The focus must be shifted away from thinking about LBP in a negative way.

Treatment of chronic LBP must take pain beliefs into consideration. Research results such as those provided from this study can help identify ways to change unhelpful beliefs in patients with chronic LBP.
Tim John Sloan, BM, BS, et al. Beliefs About the Causes and Consequences of Pain in Patients with Chronic Inflammatory or Noninflammatory Low Back Pain and in Pain-Free Individuals. In Spine. April 20, 2008. Vol. 33. No. 9. Pp. 966-972.