Beliefs About the Causes and Consequences of Pain in Patients With Chronic Inflammatory or Noninflammatory Low Back Pain and in Pain-Free Individuals.

Sloan, Tim John;  Gupta, Rajiva;  Zhang, Weiya;  Walsh, David Andrew

The objective of this case control study was to explore whether pain beliefs differ between patients with chronic LBP attributed to inflammatory or noninflammatory medical diagnoses, and between patients with chronic LBP and pain-free controls.  Patients and controls completed the pain beliefs questionnaire addressing beliefs about the causes and consequences of pain. Patients also completed questionnaires addressing catastrophizing, physical disability and bodily pain, and psychological distress. Patients with noninflammatory LBP more strongly endorsed organic pain beliefs (e.g., that pain necessarily indicates damage), and catastrophizing (e.g., that the pain is never going to get better), than did patients with inflammatory LBP. Patients with inflammatory LBP, in turn, more strongly endorsed organic pain beliefs than did pain-free controls. Endorsement of organic pain beliefs was associated with catastrophizing.

Organic pain beliefs are associated with increased catastrophizing in patients with chronic LBP, and addressing these beliefs may help patients to manage their pain and disability. Meanings attributed to inflammatory and noninflammatory diagnostic labels may contribute to the different pain beliefs held by different patient groups.

Spine, 2008, 33(9), 966-972

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