cause of low back pain

What Do People Believe to Be the Cause of Low Back Pain? A Scoping Review

The way people understand pain can significantly impact how they react to it. The common sense model is all about this—the mental representation people form about their illnesses. These representations stem from various beliefs, one of which is causal beliefs.

Many studies show that causal beliefs significantly affect and determine how people manage their condition. For example, if a person believes that weakness in the spine is the cause of their back pain, they may be more inclined to avoid certain activities or movements. These beliefs can hinder proper recommended therapy for LBP when patients feel the treatment doesn’t match what they understand as regards their pain’s cause.

Various questionnaires exist, some of which involve causal beliefs, to explore people’s beliefs about low back pain. Yet, the way causal beliefs are assessed and measured differs. This has made it hard to determine how important causal beliefs are compared to other belief domains.

Researchers of this paper1 examined how causal beliefs about low back pain are linked. The scoping review tried to map out a pattern from previous research on how studies quantitatively investigated causal beliefs. They did this to see if they could find in those studies evidence to support the findings from qualitative studies, which would have suggested a connection between causal beliefs and poor outcomes for low back pain.

Review Method

The researchers conducted their review using a stringent approach, and their findings were published in accordance with recognized norms. They examined electronic databases for relevant research and filtered them using precise criteria. They included studies that assessed causal beliefs about LBP in adults and published the results independently from other belief categories. Participants in the trials, including healthcare practitioners and clinical populations, might or may not have LBP. Studies that just focused on creating or modifying questionnaires were omitted.

The researchers characterized causal beliefs using the common-sense model. They classified a belief as causal if it pertained to the believed cause of LBP, a perceived trigger for a new beginning of LBP, or a perceived risk factor for LBP. They included research that employed a variety of approaches to assess causal beliefs as long as the methods quantified these views.

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Findings

Researchers came up with a large number of studies to be examined. Their review comprised 81 studies. These studies had 308 unique causal belief items divided into 15 separate categories. Beliefs regarding structural damage, lifting and bending activities, and mental or psychological issues were the most commonly explored causal beliefs.

Researchers used numerous questionnaires to measure causal beliefs regarding low back pain. Some were meant to test beliefs in general, while others were used to examine causal beliefs. However, not every study used validated questionnaires.

A large percentage of the studies reviewed were done in high-income countries, with researchers focusing on the main population. Fewer studies with clinical populations and healthcare professionals were also included. Cross-sectional study designs were often used, in which the researchers gathered participants’ data at a single moment. A limited amount of research has examined the relationship between causal beliefs and low back pain outcomes.

 

Analysis and Conclusion

This summary’s review showed that while causal beliefs concerning low back pain have been widely studied, a significant disparity was observed in how the beliefs were measured. Also, researchers couldn’t find studies highlighting the impact of causal beliefs over time.

The researchers concluded that people’s perceptions of their LBP are likely impacted by their causal beliefs. However, these beliefs must be tested repeatedly to determine their precise function in how people experience and manage pain. Because of the variance in measuring procedures, it is difficult to arrive at solid conclusions about the relevance of causal beliefs.
It is worth noting that causal beliefs also possibly interact with other beliefs, influencing individuals’ overall illness presentation. This intermingling makes it hard to isolate the particular effects of causal beliefs.

Strengths and Limitations of the Review

The review procedure has several limitations, which the researchers have acknowledged. One drawback is that they should have included research papers from the gray literature or unpublished studies. Also, the researchers who did the review had to exercise some subjective interpretation because several characteristics of the beliefs examined in the studies were not well defined.

Even with these drawbacks, the researchers think their review offers insightful information. They conducted their research with careful planning and openly disclosed their results. They also recognize the positive aspects of their review, including how they define causal beliefs precisely using the Common Sense Model.

 

At Dynamic Disc Designs we have worked develop models that can help with the education of common sources of low back pain.  Explore our growing line of realistic anatomical models.