Clinicians Contribute to Negative Back Pain Beliefs

Despite research showing otherwise, many patients continue to believe that bed rest and avoiding certain activities is an adequate model for recovery after a back injury. A new study sought to examine how patients develop these negative back pain beliefs, and pointed to one unifying factor: their doctors.

Research shows that this old model of thinking about back pain-- staying in bed to wait for it to get better-- actually worsens your prospects of recovery. Countless studies have shown that staying active hastens healing, prevents muscle degeneration, and allows you to strengthen your muscles to avoid future injuries. However many patients continue to exhibit fear avoidance beliefs, which have been tied to chronic back pain symptoms.

"Many messages from clinicians were interpreted as meaning the back needed to be protected," the authors wrote. "These messages could result in increased vigilance, worry, guilt when adherence was inadequate, or frustration when protection strategies failed."

Any messages to rest or avoid certain movements contributed to the idea that their backs were vulnerable, and subsequently facilitated the development of fear avoidance beliefs. At the same, clinicians could have a beneficial effect on perceptions of back pain, with reassurance and advice to stay active resulting in a positive outlook and confidence.

"Healthcare professionals have a considerable and enduring influence upon the attitudes and beliefs of people with low back pain. It is important that this opportunity is used to positively influence attitudes and beliefs," the authors concluded.

Chiropractors understand the importance of patient education and exercise therapies in treating back pain. They'll work with you to provide you with safe, symptom-targeted exercises to reduce pain; and support you in staying active during your recovery for efficient relief.


Darlow B, et al. The enduring impact of what clinicians say to people with low back pain. Annals of Family Medicine 2013. doi: 10.1370/afm.1518.