Article Text

Cross-sectional survey of attitudes and beliefs about back pain in New Zealand
  1. Ben Darlow1,
  2. Meredith Perry2,
  3. James Stanley3,
  4. Fiona Mathieson4,
  5. Markus Melloh5,
  6. G David Baxter2,
  7. Anthony Dowell1
  1. 1Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
  2. 2Centre for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
  3. 3Biostatistical Group, University of Otago, Wellington, New Zealand
  4. 4Department of Psychological Medicine, University of Otago, Wellington, New Zealand
  5. 5Centre for Health Sciences, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
  1. Correspondence to Ben Darlow; ben.darlow{at}


Objectives To explore the prevalence of attitudes and beliefs about back pain in New Zealand and compare certain beliefs based on back pain history or health professional exposure.

Design Population-based cross-sectional survey.

Setting Postal survey.

Participants New Zealand residents and citizens aged 18 years and above. 1000 participants were randomly selected from the New Zealand Electoral Roll. Participants listed on the Electoral Roll with an overseas postal address were excluded. 602 valid responses were received.

Measures Attitudes and beliefs about back pain were measured with the Back Pain Attitudes Questionnaire (Back-PAQ). The interaction between attitudes and beliefs and (1) back pain experience and (2) health professional exposure was investigated.

Results 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.

Conclusions 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.

  • Epidemiology
  • Rehabilitation Medicine
  • Pain Management
  • Primary Care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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