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The lifetime prevalence of back pain was reported as 87% (95% CI 84% to 90%), and the point prevalence as 27% (95% CI 24% to 31%). Negative views about the back and back pain were prevalent, in particular the need to protect the back to prevent injury. People with current back pain had more negative overall scores, particularly related to back pain prognosis. There was uncertainty about links between pain and injury and appropriate physical activity levels during an episode of back pain. Respondents had more positive views about activity if they had consulted a health professional about back pain. The beliefs of New Zealanders appeared to be broadly similar to those of other Western populations.
A large proportion of respondents believed that they needed to protect their back to prevent injury; we theorise that this belief may result in reduced confidence to use the back and contribute to fear avoidance. Uncertainty regarding what is a safe level of activity during an episode of back pain may limit participation. People experiencing back pain may benefit from more targeted information about the positive prognosis. The provision of clear guidance about levels of activity may enable confident participation in an active recovery.
Only one of the a priori analyses related to HCP exposure for back pain demonstrated a significant difference (see online supplementary table S2). People who had seen an HCP had significantly more positive mean scores for item 27 related to staying active during an episode of pain (p=0.002, mean difference 0.3, 95% CI 0.1 to 0.5; figure 6). Adjusting for age and sex did not substantially alter mean differences.
This sample was positive about the general prognosis for back pain, with 64% agreeing that most pain settles quickly; this compares with 44% in the UK.19 However, only 29% of the sample did not believe there would be permanent weakness following an episode of back pain (ie, the majority were unsure or believed there would be a residual weakness); this is similar to findings in an Australian sample (22%).30 The belief that back pain results in ongoing weakness is likely to result in more back protection and avoidance, as well as altered appraisals of future back pain.22 This may be a key belief for HCPs to discuss with their patients.
This survey indicates that New Zealanders generally have negative views about the back and back pain, particularly with regard to the need to protect the back to avoid injury, and the special nature of back pain. It also suggests that there is uncertainty about how pain relates to injury. Although many hold positive beliefs about continuing to be active during an episode of back pain, there was uncertainty about what constitutes a safe or appropriate level of activity during an episode of back pain. Respondents with current back pain had more negative views about prognosis; this suggests that patients experiencing pain may benefit from targeted information about the positive prognosis. The beliefs of New Zealanders appear to be broadly similar to those of other Western populations. Consequently, the findings of this survey may also be of relevance outside of New Zealand. 153554b96e