People with back pain are often unclear about prognosis and how active they should be

This paper describes a survey of New Zealanders’ beliefs about back pain conducted by Ben Darlow and colleagues at the University of Otago. One thousand people were posted a newly developed questionnaire and 600 sent back responses. The survey found that back pain is very common. Nearly 30% of respondents were experiencing back pain on the day they completed the survey and almost 90% of people had experienced back pain at some point in their lives.


Overall respondents had relatively negative beliefs about the back and back pain. The majority of respondents thought the back needed to be protected to prevent injury, and this is similar to findings from previous interview based research with a smaller group of participants which we have previously discussed here. People who had back pain when they completed the survey had more negative scores, particularly related to the likely outcome of an episode of back pain, whereas those who had seen a health professional for back pain in the past had more positive views about activity. Findings indicated that many people are uncertain about whether persistent pain is an accurate representation of tissue injury (which of course it is not), and about how active they should be when they have back pain.


The researchers suggest that beliefs about the need to protect the back to prevent injury may result in reduced confidence to use the back and unnecessary avoidance of activities due to fear of injury. Uncertainty regarding what is a safe level of activity during an episode of back pain may limit participation. Consequently, providing clear guidance about appropriate levels of activity (as much as possible, gradually increasing) may enable confident participation in an active recovery.

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