How important are back pain beliefs and expectations for satisfactory recovery from back pain?

Best Pract Res Clin Rheumatol. 2010 Apr;24(2):205-17. doi: 10.1016/j.berh.2009.12.012.


In this article, we provide an evidence-based review of pain beliefs and their influence on pain perception and response to treatment. We examine the nature of pain perception and the role of cognitive and emotional processes in the interpretation of pain signals, giving meaning to pain and shaping our response to it. We highlight three types of beliefs that have a particularly strong influence: fear-avoidance beliefs, pain self-efficacy beliefs and catastrophising. We examine the influence of beliefs, preferences and expectations on seeking consultation, interventions and treatment outcome from the perspective both of the patient and the health-care practitioner. We then adopt a broader societal perspective, considering secondary prevention and campaigns, which have attempted to change beliefs at a population level. The article concludes with a summary of the key messages for clinical management of patients presenting with painful conditions and suggestions for further research.

Publication types

  • Review

MeSH terms

  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel / psychology
  • Humans
  • Low Back Pain / physiopathology
  • Low Back Pain / psychology
  • Low Back Pain / therapy*
  • Male
  • Pain Measurement
  • Patient Acceptance of Health Care
  • Patient Satisfaction*
  • Perception
  • Recovery of Function*