Physiotherapists’ Pain Beliefs and Their Influence on the Management of Patients With Chronic Low Back Pain

Daykin, Anne; Richardson, Barbara

doi:10.1097/01.brs.0000115135.19082.97

Cited by 176 publications

(129 citation statements)

References 35 publications

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“…This is unsurprising when there is a lack of literature and education on the topic. However, it is well understood from the literature on low back pain that physiotherapists belief systems will in turn impact on patient management, and hence outcome [29]. The authors therefore recommend a further study to directly investigate the beliefs of health professionals towards PFJ crepitus.…”

Section: Having Spoken With My Physiotherapist I Know It Is Not Actuamentioning

confidence: 99%

People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study

Robertson

Hurley

Jones

2017

Musculoskeletal Science and Practice

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Section: Having Spoken With My Physiotherapist I Know It Is Not Actuamentioning

confidence: 99%

People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study

Robertson

Hurley

Jones

2017

Musculoskeletal Science and Practice

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“…The data are, however, entirely consistent with what health care professionals report providing, 13,32 people with low back pain report receiving, 14,15 and direct consultation observations. 33 Regardless of participants' recall and bias, the messages that have stayed with them are probably more important than what was actually said or intended.…”

Section: Limitationsmentioning

confidence: 99%

The Enduring Impact of What Clinicians Say to People With Low Back Pain

Darlow

Dowell

Baxter

et al. 2013

The Annals of Family Medicine

228

154

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PURPOSE The purpose of this study was to explore the formation and impact of attitudes and beliefs among people experiencing acute and chronic low back pain.METHODS Semistructured qualitative interviews were conducted with 12 participants with acute low back pain (less than 6 weeks' duration) and 11 participants with chronic low back pain (more than 3 months' duration) from 1 geographical region within New Zealand. Data were analyzed using an Interpretive Description framework.RESULTS Participants' underlying beliefs about low back pain were influenced by a range of sources. Participants experiencing acute low back pain faced considerable uncertainty and consequently sought more information and understanding. Although participants searched the Internet and looked to family and friends, health care professionals had the strongest influence upon their attitudes and beliefs. Clinicians influenced their patients' understanding of the source and meaning of symptoms, as well as their prognostic expectations. Such information and advice could continue to influence the beliefs of patients for many years. Many messages from clinicians were interpreted as meaning the back needed to be protected. These messages could result in increased vigilance, worry, guilt when adherence was inadequate, or frustration when protection strategies failed. Clinicians could also provide reassurance, which increased confidence, and advice, which positively influenced the approach to movement and activity.CONCLUSIONS Health care professionals have a considerable and enduring influence upon the attitudes and beliefs of people with low back pain. It is important that this opportunity is used to positively influence attitudes and beliefs. INTRODUCTIONL ow back pain is a health condition with major direct and indirect costs.1-4 Acute low back pain is assumed to have a highly positive prognosis 5 ; however, a large proportion of patients continue to experience pain and disability. 6 Psychosocial factors are important in the development of low back pain and disability. 7,8 Depression, passive coping strategies, fear avoidance beliefs (the avoidance of movement or activity resulting from fear of pain or injury), and low expectations of recovery are independently associated with poor outcome.9,10 A clinical guide to assessing psychosocial warning signs (yellow flags) developed in New Zealand has been adopted internationally. Patients' beliefs need to be better understood to improve management of low back pain. 10,12,13 People with low back pain receive information from a range of sources, but the influence of each source is unknown.14,15 Studies have investigated activities, situations, and anatomic structures that people see as being responsible for their back pain, but not how or why beliefs have been formed. 14,[16][17][18] Health care professionals may negatively influence patient beliefs. 19There is strong evidence that patients' beliefs about low back pain are associated with their clinicians' beliefs, and moderate evidence suggests

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“…Certain beliefs, attitudes, and disease models about pain and how it should be handled by patients and treated by physicians are formed long before students arrive in medical school (probably very early in life) and are molded by ethnic and cultural values and norms [21]. Clinicians' responses to patients' pain are also influenced by many of these same factors [22] and continue to be modified by clinical experience [23].…”

Section: Discussionmentioning

confidence: 99%

Medical residents beliefs and concerns about using opioids to treat chronic cancer and noncancer pain: A pilot study

Roth

Burgess

Mahowald

2007

JRRD

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Abstract-This study assessed and compared residents' beliefs and concerns about using opioids for treating pain in patients with cancer and noncancer low back pain (NLBP). Participants included 72 Internal Medicine and Medicine-Pediatrics residents who completed a survey questionnaire. Based on a scale of 0 = "No concern" to 10 = "Very concerned," residents expressed greater concern that treating NLBP with opioids, compared with cancer-related pain, causes addiction (6.01 vs 1.15), abuse (5.57 vs 1.39), and side effects (4.76 vs 2.87); limits other treatments (5.36 vs 1.30); draws criticism from faculty (4.33 vs 0.88); or risks sanctioning (state board 4.12 vs 1.12, legal 4.06 vs 1.17); p < 0.001 for each (paired t-tests). They had more comfort (8.94 vs 4.31) and more empathy (9.09 vs 6.79) using opioids to treat for cancer pain than NLBP and would give whatever doses necessary for pain control (8.41 vs 3.66); p < 0.001 for each. Our findings show that residents are far more concerned about using opioids to treat NLBP than cancerrelated pain.

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Physiotherapists’ Pain Beliefs and Their Influence on the Management of Patients With Chronic Low Back Pain

Abstract: The findings suggest that in order to maximize the rehabilitation potential of patients with chronic low back pain, physiotherapists need to be aware that their pain beliefs may influence their management of these patients.

Cited by 176 publications

References 35 publications

People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study

People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study

The Enduring Impact of What Clinicians Say to People With Low Back Pain

Medical residents beliefs and concerns about using opioids to treat chronic cancer and noncancer pain: A pilot study

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