Patients think the back is “Easy to Harm, Hard to Heal”

People who have back pain may view their back negatively and consequently focus on information which confirms their negative beliefs. In this qualitative study by Ben Darlow and colleagues from the University of Otago, participants who had acute and chronic low back pain perceived their back to be vulnerable to injury and in need of protection. They considered that back pain was worse than other conditions in terms of its nature and impact, and that there was a high chance that their back pain would not resolve.

These beliefs combined to create a negative (mis)representation of the back which could be considered analogous to the self-prejudice which has been described as a maintaining factor for mental health disorders like depression. Approaching consultations with the understanding that patients may have unhelpful beliefs about their back might help clinicians to focus on information which is likely to be interpreted positively, and exercise caution with information which may reinforce negative beliefs.

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