What patients think about the cause of their CLBP

The world of research has shifted the health professionals’ view from a predominantly biomedical model to a biopsychosocial model when it comes to explaining CLBP. How about the patient’s perspective?

A total of 130 participants answered the following 2 questions:

1. What is your understanding of why your low back pain is persisting or recurring?
2. Where does this understanding come from?

The answers to the first question were distributed in 4 clear patterns:

• Body as Machine. This was the most common answer where the individual viewed their body in a machine-like way. Description of the cause and persistence of their CLBP included words like joint, muscle, alignment, control, strength and inflammatory;
• LBP as permanent. This was the second most common answer where the individual not only viewed their body in a machine-like way but also the ‘damage’ to their back as relatively permanent. Words like ‘degeneration’ and description which denotes an earlier injury having long-term consequences were commonly used;
• LBP is complex. This was significantly less common compared to the above 2 patterns. Individuals who had their answers included in this category recognised the complex nature of the body regarding their biological, psychological and social aspects;
• LBP is very negative. This pattern is very similar to the first 2 views. However, this pattern was differentiated by the use of words which used negative words such as severe, awful, poor and other words implying their body was harmed.

The question as to where the individual’s understanding came from was answered as follows (in the order of frequency):

1. Health Care Provider;
2. Internet;
3. Family;
4. Friend;
5. Other.

This survey illustrates the gap between the current understanding of CLBP of patients relative to the world of research. As evidence-based clinicians, it remains important to keep in mind about the patients' belief system in order to be a more effective communicator and a physiotherapist.

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> From: Setchell et al., BMC Musculoskelet Disord 18 (2017-11-29 19:41:31) 466(Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.