Cross-sectional survey of attitudes and beliefs about back pain in New Zealand

Abstract

ObjectivesTo explore the prevalence of attitudes and beliefs about back pain in New Zealand and compare certain beliefs based on back pain history or health professional exposure.DesignPopulation-based cross-sectional survey.SettingPostal survey.ParticipantsNew Zealand residents and citizens aged 18 years and above. 1000 participants were randomly selected from the New Zealand Electoral Roll. Participants listed on the Electoral Roll with an overseas postal address were excluded. 602 valid responses were received.MeasuresAttitudes and beliefs about back pain were measured with the Back Pain Attitudes Questionnaire (Back-PAQ). The interaction between attitudes and beliefs and (1) back pain experience and (2) health professional exposure was investigated.ResultsThe lifetime prevalence of back pain was reported as 87% (95% CI 84% to 90%), and the point prevalence as 27% (95% CI 24% to 31%). Negative views about the back and back pain were prevalent, in particular the need to protect the back to prevent injury. People with current back pain had more negative overall scores, particularly related to back pain prognosis. There was uncertainty about links between pain and injury and appropriate physical activity levels during an episode of back pain. Respondents had more positive views about activity if they had consulted a health professional about back pain. The beliefs of New Zealanders appeared to be broadly similar to those of other Western populations.ConclusionsA large proportion of respondents believed that they needed to protect their back to prevent injury; we theorise that this belief may result in reduced confidence to use the back and contribute to fear avoidance. Uncertainty regarding what is a safe level of activity during an episode of back pain may limit participation. People experiencing back pain may benefit from more targeted information about the positive prognosis. The provision of clear guidance about levels of activity may enable confident participation in an active recovery.

Beliefs about back pain and pain management behaviours, and their associations in the general population: A systematic review

“…For example, a belief about trying to stay active when in pain was endorsed by 40% (95% CI: 37.9–42.1) of adults in Scotland in 2000 versus 80% (76.6–83.1) in New Zealand in 2012 (Fig. ) (Waddell et al., ; Gross et al., ; Darlow et al., ). The prevalence of agreement with a belief about the need to take it easy/rest until pain improves also varied across several studies, with 25 to 70% of samples endorsing this belief, depending on the study which varied by country and year of data collection (Ihlebæk and Eriksen, , ; Waddell et al., ; Werner et al., ; Gross et al., ; Darlow et al., ).…”

“…4) (Waddell et al, 2007;Gross et al, 2010;Darlow et al, 2014). The prevalence of agreement with a belief about the need to take it easy/rest until pain improves also varied across several studies, with 25 to 70% of samples endorsing this belief, depending on the study which varied by country and year of data collection Eriksen, 2003, 2005;Waddell et al, 2007;Werner et al, 2008;Gross et al, 2010;Darlow et al, 2014). (Ihlebaek and Eriksen, 2003;Werner et al, 2008;Elfering et al, 2009;Mannion et al, 2013).…”

The development and exploratory analysis of the Back Pain Attitudes Questionnaire (Back-PAQ)

“…The full methods and results of this study are available elsewhere 38. Participants were eligible for inclusion if they were New Zealand citizens or residents aged 18 years and above.…”

Physiotherapists implicitly evaluate bending and lifting with a round back as dangerous

“…Beliefs that the back is vulnerable, and requires protection are common among people with 1,2 and without [3][4][5][6] LBP. Encounters with health care clinicians such as physiotherapists, who provide advice about LBP, are thought to play a role in the development of such societal beliefs 7 .…”