Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 17;18(1):466.
doi: 10.1186/s12891-017-1831-7.

Individuals' explanations for their persistent or recurrent low back pain: a cross-sectional survey

Jenny Setchell  1 , Nathalia Costa  2 , Manuela Ferreira  3 , Joanna Makovey  3 , Mandy Nielsen  2 , Paul W Hodges  2
Affiliations

Individuals' explanations for their persistent or recurrent low back pain: a cross-sectional survey

Jenny Setchell et al. BMC Musculoskelet Disord. .

Abstract

Background: Most people experience low back pain (LBP), and it is often ongoing or recurrent. Contemporary research knowledge indicates individual's pain beliefs have a strong effect on their pain experience and management. This study's primary aim was to determine the discourses (patterns of thinking) underlying people's beliefs about what causes their LBP to persist. The secondary aim was to investigate what they believed was the source of this thinking.

Methods: We used a primarily qualitative survey design: 130 participants answered questions about what caused their LBP to persist, and where they learned about these causes. We analysed responses about what caused their LBP using discourse analysis (primary aim), and mixed methods involving content analysis and descriptive statistics to analyse responses indicating where participants learnt these beliefs (secondary aim).

Results: We found that individuals discussed persistent LBP as 1) due to the body being like a 'broken machine', 2) permanent/immutable, 3) complex, and 4) very negative. Most participants indicated that they learnt these beliefs from health professionals (116, 89%).

Conclusions: We concluded that despite continuing attempts to shift pain beliefs to more complex biopsychosocial factors, most people with LBP adhere to the traditional biomedical perspective of anatomical/biomechanical causes. Relatedly, they often see their condition as very negative. Contrary to current "best practice" guidelines for LBP management, a potential consequence of such beliefs is an avoidance of physical activities, which is likely to result in increased morbidity. That health professionals may be the most pervasive source of this thinking is a cause for concern. A small number of people attributed non-physical, unknown or complex causes to their persistent LBP - indicating that other options are possible.

Keywords: Discourse analysis; Lumbar; Pain trajectories; Patient perspectives; Psychosocial.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was given by the University of Queensland’s Behavioural and Social Sciences Ethical Review Committee. Approval number 2015001094. Informed consent was obtained from all participants. Before entering the online survey, participants read information about the study and were required to indicate their consent before entering the survey (by choosing ‘next’). This process was approved by the institutional ethics committee.

Consent for publication

Not applicable.

Competing interests

MC is a member of the editorial board of BMC Musculoskeletal Disorders. The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2013;380(9859):2163–2196. doi: 10.1016/S0140-6736(12)61729-2. - DOI - PMC - PubMed
    1. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64:2028–2037. doi: 10.1002/art.34347. - DOI - PubMed
    1. Young AE, Wasiak R, Phillips L, Gross DP. Workers’ perspectives on low back pain recurrence: "it comes and goes and comes and goes, but it's always there". Pain. 2011;152(1):204–211. doi: 10.1016/j.pain.2010.10.033. - DOI - PubMed
    1. Axen I, Leboeuf-Yde C. Trajectories of low back pain. Best Pract Res Clin Rheumatol. 2013;27(5):601–612. doi: 10.1016/j.berh.2013.10.004. - DOI - PubMed
    1. Kongsted A, Kent P, Axen I, Downie A, Dunn KM. What have we learned from ten years of trajectory research in low back pain? BMC Musculoskelet Disord. 2016;17(1):220. doi: 10.1186/s12891-016-1071-2. - DOI - PMC - PubMed