Community survey of factors associated with consultation for low back pain

ObjectiveTo investigate the psychosocial factors associated with consultation for low back pain.DesignTwo phase cross sectional postal survey.SettingBradford Metropolitan Health District.Subjects1813 adults responding to the phase 1 questionnaire. 540 of the 782 with an episode of low back pain in the past 12 months completed the second questionnaire.Results406 (52%) of the respondents reporting back pain in the past 12 months had not consulted a health professional. Logistic regression showed that consultation was associated with externalised beliefs regarding pain management (odds ratio 3.6; 95% confidence interval 2.1 to 6.0). Duration of pain affected the factors associated with consultation. Consultation for episodes lasting less than two weeks (n=290) was associated with greater than median pain (3.0; 1.7 to 5.5), consultation for episodes over two weeks (n=243) was associated with increased disability (3.7; 1.5 to 9.0), and consultation for episodes over three months (n=143) with increased depression (3.9; 1.3 to 11.8).ConclusionsThe results support a role for psychosocial factors in consultation for low back pain and suggest that the reasons for consultation vary with duration of pain. Duration of the episode may be a useful guide to management of non-specific low back pain.

Key messages

• Only half of those who experience low back pain consult a health service professional
• Most of those who consult have had low back pain for more than two weeks
• The severity of pain may influence consulting behaviour at the acute stage, but after the acute period those who consult are more likely to have increased disability, externalised beliefs about pain management, and depressive symptoms.
• Management of low back pain may need to vary according to the duration of pain