Demographics
428 surveys were returned (14% response rate). The average age of the sample was 55 years (SD 14.6 years) and 66% of respondents were female. Of the total sample, 386 (90.2%) reported a history of low back pain, of which 252 reported low back pain within the last week (Table 1).
Table 1. Demographics, LBP characteristics and outcomes of survey participants (total n=428)
Item
|
Score
|
# missing
|
Age (Mean, SD)
|
55.35 (14.67)
|
0
|
Female (N, %)
|
281 (66.0)
|
2
|
Back Pain Characteristics
|
|
History of low back pain (N, %)
|
386 (90.2)
|
0
|
Low back pain in the last 12 months (N, %) *
|
339 (88.8)
|
4
|
Low back pain in the last week (N, %) *
|
252 (74.6)
|
48
|
Last episode of low back pain severity [0-10] (mean, SD) *
|
5.8 (2.3)
|
5
|
Care seeking for low back pain (N, %) *
|
200 (52%)
|
3
|
*these questions were only answered by the sample of people who reported a history of back pain (n=386), the percentage is calculated from completed responses only.
|
Self-report of treatment and care seeking behaviours (n=386)
These questions only applied to the 386 participants who had reported they had had LBP. When asked about what they did for their back pain, 49.5% took painkillers, 46.4% reported they rested or avoided activity, 36.8% reported other types of activities (e.g. heating pad or ice pack, stretching, or massage therapy), 28.2% did some physical activity, 14.5% reported that they went to bed or lay down, 6.2% took time off work, and 10.4% did nothing. Of the 386 people who had ever had low back pain, 200 (52%) said they sought medical or professional help with their back pain. Of these 200 people, most saw a family doctor (72%), chiropractor (38.5%), physiotherapist (30.5%), massage therapist (28%), or pharmacist (5.5%). 11.5% of people reported ‘other’ and listed a variety of other health providers (e.g. acupuncturist, homeopathic doctor, orthopaedic surgeon, emergency doctor or osteopath). Of the 200 respondents who sought medical/professional help, 52% were advised to take painkillers, 48.5% were advised to stay active, 42% received referral for imaging, and 29.5% advised to rest or avoid activity, 13.5% were referred to a specialist, 10.5% were advised to take time off work and 4% were advised to go to bed or lay down. 33.5 % of respondents reported receiving other types of advice including exercising, stretching, losing weight and using hot or cold packs.
Back Beliefs Questionnaire
The mean Back Beliefs Questionnaire score for the cohort was 27.3 (SD = 7.2), indicating that our population sample believed that back pain has inevitable negative consequences. Across the 9 items, approximately 25% of the sample were unsure if they agreed or disagreed with the belief statements. There were 3 items in which more than 40% of respondents held negative beliefs that are contrary to evidence-based management of LBPhaving back pain meant you would always have weakness in your back, (ii) it would get progressively worse, and (iii) that resting was good.
Table 2. The Back Beliefs Questionnaire (9 items for scoring)
BBQ item
|
# of respondents
|
Disagree (1 &2)
n (%)
|
Neutral (3)
n (%)
|
Agree (4&5)
n (%)
|
1. There is no real treatment for back trouble (item1)
|
420
|
245 (58.3)
|
110 (26.2)
|
65 (15.5)
|
2. Back trouble will eventually stop you from working (item 2)
|
417
|
172 (41.2)
|
103 (24.7)
|
142 (34.1)
|
3. Back trouble means periods of pain for the rest of one’s life (item 3)
|
416
|
121 (29.1)
|
103 (24.8)
|
192 (46.2)
|
4. Back trouble makes everything in life worse (item 6)
|
417
|
104 (24.9)
|
129 (30.9)
|
184 (44.1)
|
5. Back trouble means you end up in a wheelchair (item 8)
|
421
|
253 (60.1)
|
101 (24.0)
|
67 (15.9)
|
6. Back trouble means long periods of time off work (item 10)
|
414
|
211 (51.0)
|
119 (28.7)
|
84 (20.3)
|
7. Once you have had back trouble there is always a weakness (item 12)
|
418
|
122 (29.2)
|
90 (21.5)
|
206 (49.3)
|
8. Back trouble must be rested
(item 13)
|
415
|
89 (21.4)
|
154 (37.1)
|
172 (41.4)
|
9. Later in life back trouble gets progressively worse (item 14)
|
417
|
94 (22.5)
|
123 (29.5)
|
200 (48.0)
|
Beliefs about activity, rest and the use of imaging and pain killers
While just over half of respondents agreed (55.2%) that if they had back pain they should try to stay active, many also agreed (23.9%) or were unsure (38.2%) that they should rest until they got better which was similar to beliefs about going to work (26.8% agreed and 34.1% were unsure). In terms of analgesics, about half of respondents (47.8%) did not think that simple painkillers were enough to control most back pain. In terms of imaging, 53% thought that x-rays or scans are necessary to get the best medical care for LBP, and 24.8% were unsure. Similarly, 48.8% thought that everyone with LBP should have an image and 23.1% were unsure. Overall, it appears that about 50% of respondents hold beliefs that are contrary to evidence-based management regarding the use of imaging with another 20% being unsure. In terms of resting or remaining active and going to work and taking pain killers, a large proportion (approximately 35%) were unsure about the best course of action.
Table 3. Additional beliefs about activity, rest, and the use of imaging and pain killers
Belief statements
|
# of respondents
|
Disagree (1 & 2)
n (%)
|
Neutral (3)
n (%)
|
Agree (4 &5)
n (%)
|
1. X-rays or scans are necessary to get the best medical care for low back pain
|
419
|
86 (20.5)
|
106 (25.3)
|
227 (54.2)
|
2. Everyone with low back pain should have spine imaging (e.g X-ray, CT, MRI)
|
416
|
108 (26.0)
|
99 (23.8)
|
209 (50.2)
|
3. If you have back pain, you should rest until it gets better
|
419
|
159 (37.9)
|
160 (38.2)
|
100 (23.9)
|
4. If you have back pain, you should try to stay active
|
417
|
46 (11.0) bad
|
141 (33.8)
|
230 (55.2)
|
5. Simple painkillers are usually enough to control most back pain
|
418
|
200 (47.8) bad
|
118 (28.2)
|
100 (23.9)
|
6. Most back pain settles quickly, and you can get on with normal activities such as going to work
|
422
|
165 (39.1) bad
|
144 (34.1)
|
113 (26.8)
|