Unhelpful beliefs and attitudes about low back pain in the general population: A cross-sectional survey

Background: Unhelpful beliefs about non-specific low back pain (LBP) are associated with poorer coping strategies and unhelpful behaviours. Furthermore, targeting unhelpful beliefs about back pain has been advanced as a major priority to decrease the burden of LBP. Therefore, studies exploring these beliefs are needed to adapt the message delivered to the population. Objectives: To identify attitudes and beliefs about LBP in the general population in French-speaking Switzerland and to analyse their association with individual characteristics and the belief that exercise is an effective treatment for LBP. Design: Cross-sectional study. Method: Attitudes and beliefs were measured with the Back-Pain Attitudes Questionnaire (Back-PAQ). Individual characteristics and participants' beliefs about the effectiveness of exercise for LBP were collected to determine their association with Back-PAQ score. Results: The questionnaire was completed by 1129 participants. Unhelpful beliefs were widespread (mean (SD) Back-PAQ score: 113.2 (10.6)), especially those that the back needs protection, is easy to injure and that the nature of LBP is special. Only 55% of the participants believed exercise to be one of the most effective treatment for LBP. Individual characteristics only explained 4% of the Back-PAQ score variance. Conclusion: French-speaking Swiss general population has high levels of unhelpful beliefs and moderate confidence in the effectiveness of exercise for LBP, though the message "staying active is good for LBP" was well understood. The messages to decrease the level of unhelpful beliefs about LBP in the population should specifically target the vulnerability, protection and special nature of LBP, and promote exercise therapy.