Attitudes and beliefs of acute low back pain in Cotonou: influence on the transition to chronicity

Amanzonwé ER, Sebgo B, Alagnidé HE, Kpadonou GT

University Clinic for Physical Medicine and Rehabilitation, National Hospital and University center Hubert K. Maga, Street Pape Jean-Paul  II, 01 BP 386 Cotonou/Benin

Correspondence: Amanzonwé Elogni Renaud   geselladley@gmail.com

Background and purpose

The management of low back pain is intended to be biopsychosocial and not purely biomedical as in the past. Psychosocial factors play a significant role in the development of this disease. The aim of the present study was to analyze the influence of attitudes and beliefs of acute low back pain (ALBP) on their transition to chronicity.

Relevance

The physiotherapist is one of the principal actors in the management of LBP. The recognition of psychosocial factors will better direct him in the management of LBP and preventing its chronicity.

Participants/ Subjects

This study included ALBP patients, aged ≥ 18 years without history of back surgery and who agreed participate in the study.

Methods

This is a prospective, descriptive and analytical study, including ALBP patients. Participants were evaluated using the Start Back tool, Fear-Avoidance Beliefs (FABQ) Questionnaire and Beck Depression Inventory (BDI). The transition to chronicity was assessed 3 months after the pain onset by telephone call.

Analysis

The data were processed by the software “Epi Info version 3.3 of 2007”. The chi-square test was used to determine if any associations existed between the qualitative and quantitative variables. The alpha significant level was set at 0.05.

Results

Thirty two ALBP patients were recruited. The sex ratio was 1.28 in favor of men. The mean age of participants was 43.46 ± 12.9 years. The majority of patients were overweight (65.62%) with a BMI ranging from 17.70 to 36.85 kg/m². Out of the 32 ALBP patients, 18 (56.25%) moved to the chronic phase. Fourteen (43.75%) ALBP patients received both drug and physiotherapy treatment, among, only one passed into chronic phase (7.14%) compared to 18 ALBP patients who received only drug treatment, 17 (94.44%) have moved into the chronic phase. Most patients (71.87%) believe that it is true to limit activities when your back hurts and you should not lean forward. The mode of pain installation (p=0.03) and treatment received (p=0.001) were significantly associated with the transition to chronicity. The « permanent wearing of lumbar belt » (p=0.02), « walking for relief » (p=0.005) and « sitting over 2 hours » (p=0.03) were significantly associated with the shift to chronicity. The Start Back presented a significant result for the risk assessment of transition to chronicity (p=0.007)

Conclusion
Attitudes and beliefs have a significant correlation with the transition to chronic low back pain.

Implications

The early education/information of the physiotherapist of the "mistaken" attitudes and beliefs is necessary to prevent chronicity.

Keywords

Low Back Pain – Attitudes –Beliefs

Funding source

This work was unfunded

Ethics Committee

This work has been approved by the NHUC-HKM Ethics Committee