PTSystematic ReviewBrazilian journal of physical therapy2023

What do people believe to be the cause of low back pain? A scoping review.

Søren Grøn, Kasper Bülow, Tobias Daniel Jonsson and 2 others

PMID 37972538

WHAT IT FOUND

Current research cannot quantify how specific beliefs about the cause of low back pain affect patient outcomes.

Studies use inconsistent measures, making it impossible to separate causal beliefs from other factors or determine their true clinical impact.

Key findings

01It is not feasible to quantify the impact of causal beliefs on low back pain outcomes due to large variations in how these beliefs are measured.

02Only 15 of the 81 included studies had an aim specifically focused on investigating causes, triggers, or etiology of low back pain.

03Most included studies used cross-sectional designs, with only 8 investigating longitudinal associations between causal beliefs and outcomes.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The definition of 'causal beliefs' was subjective, and the distinction between causes and aggravating factors may have biased the selection toward biomedical beliefs. Many included studies used non-validated or ad-hoc questionnaires, making it difficult to compare results across studies. The review did not include gray literature or non-English articles, which may have missed relevant data. Most studies were cross-sectional, so they cannot show whether causal beliefs predict future outcomes or recovery.

Declared interests

One author receives financial support from the Danish Foundation for Chiropractic Research and Postgraduate Education. The funders were not involved in the study design, analysis, or interpretation.

The easy way to misread this

Do not interpret the prevalence of 'structural injury' beliefs as evidence that these beliefs cause disability. The review found no consistent evidence linking specific causal beliefs to patient outcomes because the measurements were too heterogeneous to draw firm conclusions.

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