(8) Psychological Risk Factors in Back Pain Flashcards
What are the 3 types of psychological factors?
- Cognitive aspects (thinking)
- Emotional response (feeling)
- Pain behaviours
What are the cognitive aspects?
- negative beliefs, judgements
- catastrophic thoughts & anxiety
- expectations
- low confidence or pain self efficacy
What do people believe about back pain?
- easy to harm, hard to heal
- back pain caused by injury and damage
- the spine is vulnerable
What do people believe about back pain being caused by an injury?
- one third cant recall a trigger
- emotional and physical factors common triggers
- two thirds have recurrence
What is known about back pain caused by tissue damage?
- very common in people without pain
- symptom severity does not correlate with pathology
- positive outcomes despite persistence
- 30% have persistent pain post op
Does back pain mean something is out of place?
No good evidence for it
Is back pain caused by ‘posture’ or ‘weak core’?
Little evidence for the way we sit or stand & lack of core stability
Is it dangerous to bend?
No good evidence that there is a best lifting technique & no perfect lifting posture
What is known about rest and exercise for back pain?
- rest delays recovery
- it is safe to exercise with pain
What is known about staying at work with back pain?
- staying at work is better
- the longer a patient is absent, the less likelihood of a safe return
What are catastrophic thoughts & anxiety?
- focusing on irrational forecasting of future events
- patients imagine worst possible outcome
What effects can expectations have on recovery?
- expecting poor recovery may increase risk of non-recovery
- negative expectations of treatment and health professionals may reduce benefit
How can low pain self efficacy influence recovery?
Higher levels of self efficacy = lower levels of pain and disability in patients with chronic pain
What are emotional responses that can influence recovery?
- fear
- low mood/depressed mood
How can fear influence recovery?
- fearful beliefs about movement, exercise, and activity linked poorer outcomes
- can lead to avoidance behaviours
