Clinicians influence patients’ attitudes to back pain

Tuesday 12 November 2013

Clinicians influence patients’ attitudes to back pain

Although people with low back pain consult with the Internet, family and friends for information and understanding of their symptoms, new research shows health care professionals appear to have the strongest influence on patients’ attitudes and beliefs.

Through interviews with 23 people with acute or chronic low back pain, University of Otago Wellington researchers found information and advice from clinicians had the most significant and enduring influence on patients’ attitudes. Such information could often impact their beliefs for many years, says the study’s lead author Ben Darlow.

“Notably, we found messages from clinicians that were interpreted as meaning the back is vulnerable and needed to be protected could result in increased vigilance, worry, frustration, and guilt for patients,” Darlow says.

In contrast, reassurance and encouragement of activity could have long-term positive effects.

These findings paint a discouraging picture of the role clinicians may unwittingly play in the management of low back pain, the researchers say. They’re calling on clinicians to offer clear advice that will empower patients and positively influence their approach to movement and activity.

Attitudes and beliefs are important in the development of low back pain and disability, Darlow says. Depression, passive coping strategies, the avoidance of movement or activity resulting from fear of pain or injury, and low expectations of recovery are all associated with poor outcomes.

“Our findings suggest clinicians need to be aware of their own beliefs and the influence of these on their patients, as well as the ways in which their explanations may be interpreted by patients.”

The research reinforces the importance of communication during health care consultations and of checking patients’ understanding of any messages provided, Darlow says.

The research has been published in the latest issue of the international journal Annals of Family Medicine.

ENDS

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