Understanding cultural influences on back pain and back pain research

Henschke, Nicholas; Lorenz, Eva; Pokora, Roman; Michaleff, Zoe A; Quartey, Jonathan; Oliveira, Vinícius Cunha

doi:10.1016/j.berh.2017.08.004

Cited by 45 publications

(30 citation statements)

References 76 publications

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“…The different belief system of LBP population in China found in our study, supports research that suggests that cultural factors in uence pain-related factors (29,30,(58)(59)(60). For example, in contrast with the overwhelming LBP medical care in the West (13,21,28), a Nepalese study showed that people who suffered from LBP continued with their daily activities without seeking medical help as they consider LBP to be a normal aging process (58).…”

Section: Discussionsupporting

confidence: 79%

How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey

Coppieters

Setchell

et al. 2020

Preprint

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Background: Low back pain (LBP) is the second highest cause of health burden in China. Delayed recovery, poor clinical outcomes and persistence of LBP are associated with negative pain beliefs about LBP. Chinese philosophies are nested into the daily life of people in China, which is likely to influence pain beliefs. However, there is lack of knowledge about people’s thinking patterns (discourses) regarding their LBP in China. The primary aim of this study was to explore the discourses underlying the beliefs of people in China about what causes their persistent or recurrent LBP. The secondary aim was to investigate the sources of these pain beliefs.Methods: People (n=152) from South Central, East and North Mainland China with LBP completed an online survey about what they believed caused their persistent or recurrent LBP and where these understandings came from. Potential causes of persistent or recurrent LBP were explored qualitatively using discourse analysis. The sources of these discourses were assessed by descriptive statistics with conventional content analysis. Results: Five discourses were identified to underpin participants’ beliefs about what caused their persistent or recurrent LBP, namely: (1) biomedical problems (66.4%), (2) unbalanced lifestyle (48.7%), (3) menstruation and ‘kidney’ status (9.2%), (4) the ‘Five Elements’ imbalance (7.9%), and (5) energy status (5.9%). Most participants responded that their pain beliefs were based on information derived from healthcare professionals (59.2%), followed by the internet (24.3%) and family (23.0%).Conclusions: People from moderately and well-developed parts of Mainland China think predominantly in line with a Western biomedical viewpoint about their LBP. Traditional Chinese medicine related pain beliefs mainly to the concept of ‘balance’ were evident on contemporary Chinese society’s understandings of LBP. These cultural beliefs could be relevant to consider in LBP management and involve healthcare professionals, family and patient in this process.

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Section: Discussionsupporting

confidence: 79%

How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey

Coppieters

Setchell

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…We have also attempted to address any potential issues by not overstating the comparisons between the ndings of the two studies. The different belief system of LBP population in China found in our study, supports research that suggests that cultural factors in uence pain-related factors (19,33,34,61,63). For example, in contrast with the overwhelming LBP medical care in the West (14,25,32), a Nepalese study showed that people who suffered from LBP continued with their daily activities without seeking medical help as they consider LBP to be a normal aging process (61).…”

Section: Discussionsupporting

confidence: 78%

“…There is now considerable research, predominantly conducted in the West, that suggests that attributing LBP to an anatomical basis has an important in uence on patients' beliefs. These pain related beliefs are considered to be formed by an individual's past experience of pain and healthcare (18) as well as cultural in uences (19). There is also a large body of research which suggests that there are psychological effects of such biological pain beliefs such as fear avoidance, low self-e cacy and pain catastrophizing beliefs which are related to delayed recovery, poor clinical outcome and chronicity of LBP (20)(21)(22)(23).…”

mentioning

confidence: 99%

How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey

Coppieters

Setchell

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: Low back pain (LBP) is the second highest cause of health burden in China. Delayed recovery, poor clinical outcomes and persistence of LBP are associated with negative pain beliefs about LBP. Chinese philosophies are nested into the daily life of people in China, which is likely to influence pain beliefs. However, there is lack of knowledge about people’s discourses regarding their LBP in China. The primary aim of this study was to explore the discourses underlying the beliefs of people in China about what causes their persistent or recurrent LBP. The secondary aim was to investigate the sources of these pain beliefs. Methods: People (n=152) from South Central, East and North Mainland China with LBP completed an online survey about what they believed caused their persistent or recurrent LBP and where these understandings came from. Potential causes of persistent or recurrent LBP were explored qualitatively using discourse analysis. The sources of these discourses were assessed by descriptive statistics with conventional content analysis. Results: Five discourses were identified to underpin participants’ beliefs about what caused their persistent or recurrent LBP, namely: (1) biomedical problems (66.4%), (2) unbalanced lifestyle (48.7%), (3) menstruation and ‘kidney’ status (9.2%), (4) the ‘Five Elements’ imbalance (7.9%), and (5) energy status (5.9%). Most participants responded that their pain beliefs were based on information derived from healthcare professionals (59.2%), followed by the internet (24.3%) and family (23.0%). Conclusions: People from moderately and well-developed parts of Mainland China think predominantly in line with a Western biomedical viewpoint about their LBP. Traditional Chinese medicine related pain beliefs mainly to the concept of ‘balance’ were evident on contemporary Chinese society’s understandings of LBP. These cultural beliefs could be relevant to consider in LBP management and involve healthcare professionals, family and patient in this process.

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“…The cultural, social, and political environment of back pain can influence the perception of pain, the disability created, and the use of health care [ 4 ]. High-quality economic appraisals of looking at surgery when compared to conservative care (with the use of different treatment options) are needed in chronic low back pain (CLBP) patients [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Physical Therapy Approaches in the Treatment of Low Back Pain

Shipton

2018

Pain Ther

118

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Globally, in 2016, low back pain (LBP) contributed 57.6 million of total years lived with disability. Low Back Pain Guidelines regularly recommend the use of physical exercise for non-specific LBP. Early non-pharmacological treatment is endorsed. This includes education and self-management, and the recommencement of normal activities and exercise, with the addition of psychological programs in those whose symptoms persist. The aim of physical treatments is to improve function and prevent disability from getting worse. There is no evidence available to show that one type of exercise is superior to another, and participation can be in a group or in an individual exercise program. Active strategies such as exercise are related to decreased disability. Passive methods (rest, medications) are associated with worsening disability, and are not recommended. The Danish, United States of America, and the United Kingdom Guidelines recommend the use of exercise on its own, or in combination with other non-pharmacological therapies. These include tai chi, yoga, massage, and spinal manipulation. Public health programs should educate the public on the prevention of low back pain. In chronic low back pain, the physical therapy exercise approach remains a first-line treatment, and should routinely be used.

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Understanding cultural influences on back pain and back pain research

Cited by 45 publications

References 76 publications

How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey

How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey

How do people in China think about causes of their back pain? A predominantly qualitative cross-sectional survey

Physical Therapy Approaches in the Treatment of Low Back Pain

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