Disability and beliefs about back pain

I recently received an email update from Biomed Central about Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women  by Urquhart D, Bell R, Cicuttini F, Cui J, Forbes A, Davis S in BMC Musculoskeletal Disorders, 2008 9:148 ( 4 November 2008 )

(Open Access is a post for another time, however check out the Biomed Central link to the right for access to articles for free).

Given the clinical I am in and the patients I see (a lot of back pain, disability, and negative beliefs), the title caught my eye.  Not a particular surprise, but they did find an association between the beliefs about back pain (that are not supported by literature) and the level of self-reported disability (more negative beliefs, more disability), for those who experience low vs high pain (no association between no and low pain).  They did note that they do not know which may cause which.  Personally I would like to have seen them control for SES and for education, as that may impact a person’s outlook on their disability (if you or your household have more income, or you have a higher education, would that impact your beliefs about LBP and would you have less disability?).

Why write/reflect about this?  Considering my clients, I need to be sure that a) I’m educating them, both on their condition and the recovery process, and b) while the authors don’t know if beliefs result in disability or disability results in beliefs, we can work on both.  This requires that I am up to speed on my treatments and on the evidence for both treatment and the pathology.  So much to learn, so little time…




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