Back Pain Beliefs and their Impact on Treatment Seeking Behaviour

• Author / Creator

  Bell-Moratto, Alexander

• Background: Back pain is the world’s leading cause of disability, and has high associated cost.
  Psychosocial factors such as unhelpful, maladaptive beliefs can be instrumental in the transition
  from acute to chronic disabling back pain. One such maladaptive belief is that back pain is due to
  serious spinal pathology and therefore requires rest. Many mass media campaigns have been
  undertaken in an effort to impact back pain beliefs (including staying active during bouts of back
  pain), but only a select few campaigns have had a significant impact on health behaviours.
  Objectives: To determine the clinical and demographic factors associated with holding adaptive
  vs maladaptive beliefs about physical activity during back pain. To test if believing people
  should stay active with back pain is associated with often back pain is discussed with healthcare
  providers. Finally, to see if respondents that endorse ‘staying active with back pain’ utilize more
  physically active treatments compared to people endorsing maladaptive beliefs.
  Methods: Secondary analysis of a cross sectional survey evaluating a mass media campaign.
  1979 Canadian adults were surveyed between 2014-2017. Questions included demographic and
  clinical factors, a 5-point Likert scale of their agreement with the statement “If you have back
  pain, you should stay active”, and information about their healthcare use and treatment
  preference. The nonparametric Kruskal-Wallis Test was used to compare respondents who
  endorsed the ‘stay active’ belief, to those who endorse rest.
  Results: Average pain rating was the only demographic/clinical factor that statistically differed
  based on respondents’ agreement that people should stay active with back pain (p < 0.01).
  Treatment preference lacked differentiation based on agreement with the stay active belief (p =
  0.02). Agreement with the ‘stay active’ belief was associated with more discussions with
  healthcare practitioners about back pain treatment (p = 0.01).
  iii
  Implications: The link between average pain score and beliefs was small and likely not
  meaningful. Considering other research, some demographic/clinical factors may have been
  oversimplified in the analysis. Treatment preference also lacked differentiation based on
  agreement with the stay active belief. Further research is needed in order to clarify this
  relationship. This study did display that beliefs are pertinent to treatment behaviour in back pain.
  Other research has shown that mass media campaigns on this topic have changed beliefs but
  struggle to change behaviours. Rather than targeting beliefs at a population level, perhaps a
  better strategy would be ensuring practitioners properly address beliefs during clinical
  interactions. A limitation for generalizing these findings are that the majority of respondents
  agreed with the ‘stay active’ belief, therefore the results should be verified using objective
  measures.

• Subjects / Keywords

  • treatment seeking
  • back pain
  • psychological factors
  • beliefs
  • treatment behaviours

• Graduation date

  Fall 2019

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-rr1e-xa20

• License

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