Meyer M1, Pizzolato V1, Christe G1
1School of Health Science (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Department of Physiotherapy, Lausanne, Switzerland
Background: Low back pain (LBP) is a multidimensional condition that can be negatively influenced by unhelpful attitudes and beliefs. Negative beliefs about back pain are associated with poorer coping strategies and unhelpful behaviours that can increase the risk of chronicity. Therefore, having a better understanding of the attitudes and beliefs about back pain in the general population is essential, particularly in Switzerland where no data is currently available.
Purpose: To identify the attitudes and beliefs about back pain in the French-speaking part of Switzerland.
Methods: A cross-sectional survey was performed by distributing via social media the Back-Pain Attitudes Questionnaire (34 questions, score from 34 to 170, the higher the more unhelpful beliefs). People studying or working in the fields of physiotherapy, chiropractic or osteopathy were excluded from the study. Mean, standard deviations (SD), and proportions of participants (%) selecting each response were calculated for the whole sample and for pre-determined sub-groups (gender, age, level of education, field of activity, actual or previous LBP, physical activity or not).
Results: 1129 participants completed the questionnaire (mean (SD) age = 36,1 (13,3), 71% female, 62% tertiary education, 77% physically active). The lifetime and point prevalence of LBP was 96% and 47%, respectively. The mean (SD) score was 113.2 (10.6), suggesting a majority of unhelpful beliefs. Results per sub-groups were similar from each other's, with mean values ranging from 111.2 to 118.5. Helpful beliefs were found, such as the importance of staying active (true for 84%) and that emotions can influence LBP (true for 83%). Conversely, unhelpful beliefs were largely present, such as that the back can be easily injured (83%), the need to have a good posture to protect it (99.1%), and the importance of identifying specific causes (78%) and seeking care (78%).
Conclusion(s): These results suggest a majority of unhelpful beliefs about back pain in the general population in Switzerland. These beliefs were not related to individual factors, suggesting that they are consistently present in this population. Moreover, despite knowing that staying active is essential with LBP, participants still considered the back easy to injure and therefore one to be protected. Furthermore, even though they acknowledged some psychological factors, this condition is strongly seen as biomedical in its nature, with specific movements and postures that need to be avoided, and specific care that has to be provided.
Implications: The attitudes and beliefs found in this study might foster unhelpful behaviours that could increase the risk of poor prognosis, such as avoidance or care seeking. Discrepancy between helpful and unhelpful beliefs suggests that messages about back pain should go further than “staying active is good for the back”. Particularly, more specific messages that suggest that the back is strong and can tolerate loads through various movements (such as flexion) and postures, and that the condition do not need a specific diagnosis and treatment in the majority of the cases should be promoted in order to encourage positive behaviours. Further research should investigate if attitudes and beliefs can positively evolve with these messages.
Keywords: low back pain, beliefs, survey
Funding acknowledgements: This study was not funded
Purpose: To identify the attitudes and beliefs about back pain in the French-speaking part of Switzerland.
Methods: A cross-sectional survey was performed by distributing via social media the Back-Pain Attitudes Questionnaire (34 questions, score from 34 to 170, the higher the more unhelpful beliefs). People studying or working in the fields of physiotherapy, chiropractic or osteopathy were excluded from the study. Mean, standard deviations (SD), and proportions of participants (%) selecting each response were calculated for the whole sample and for pre-determined sub-groups (gender, age, level of education, field of activity, actual or previous LBP, physical activity or not).
Results: 1129 participants completed the questionnaire (mean (SD) age = 36,1 (13,3), 71% female, 62% tertiary education, 77% physically active). The lifetime and point prevalence of LBP was 96% and 47%, respectively. The mean (SD) score was 113.2 (10.6), suggesting a majority of unhelpful beliefs. Results per sub-groups were similar from each other's, with mean values ranging from 111.2 to 118.5. Helpful beliefs were found, such as the importance of staying active (true for 84%) and that emotions can influence LBP (true for 83%). Conversely, unhelpful beliefs were largely present, such as that the back can be easily injured (83%), the need to have a good posture to protect it (99.1%), and the importance of identifying specific causes (78%) and seeking care (78%).
Conclusion(s): These results suggest a majority of unhelpful beliefs about back pain in the general population in Switzerland. These beliefs were not related to individual factors, suggesting that they are consistently present in this population. Moreover, despite knowing that staying active is essential with LBP, participants still considered the back easy to injure and therefore one to be protected. Furthermore, even though they acknowledged some psychological factors, this condition is strongly seen as biomedical in its nature, with specific movements and postures that need to be avoided, and specific care that has to be provided.
Implications: The attitudes and beliefs found in this study might foster unhelpful behaviours that could increase the risk of poor prognosis, such as avoidance or care seeking. Discrepancy between helpful and unhelpful beliefs suggests that messages about back pain should go further than “staying active is good for the back”. Particularly, more specific messages that suggest that the back is strong and can tolerate loads through various movements (such as flexion) and postures, and that the condition do not need a specific diagnosis and treatment in the majority of the cases should be promoted in order to encourage positive behaviours. Further research should investigate if attitudes and beliefs can positively evolve with these messages.
Keywords: low back pain, beliefs, survey
Funding acknowledgements: This study was not funded
Topic: Musculoskeletal: spine; Pain & pain management; Non-communicable diseases (NCDs) & risk factors
Ethics approval required: No
Institution: Swiss Ethics
Ethics committee: Commission cantonale d'éthique de la recherche sur l'être humain VAUD
Reason not required: anonymous data (not coded) - art. 25 de l’ORH
All authors, affiliations and abstracts have been published as submitted.
