Effect of The Back Book on fear-avoidance beliefs, disability, and pain levels in subjects with low back pain

Background/Aim: The Back Book was designed as an evidenced-based booklet to change patients' beliefs and behaviours regarding back pain. This information focused on encouragement of normal activity, avoiding too much rest and maintaining a positive attitude. Previous studies have shown that The Back Book, when combined with other management strategies, appears to have a positive effect on patients' beliefs about back pain and clinical outcomes. This study aimed to determine the effect of The Back Book on attitudes towards back pain, function, and pain when given to patients on a waiting list to see a physiotherapist in a spinal pain clinic (SPC). Method: Subjects were recruited from a SPC waiting list and randomized into experimental and control groups. All subjects completed the Back Beliefs, Fear Avoidance Beliefs, and Roland Morris Disability questionnaires, and Visual Analogue Scale for pain before and after reading The Back Book or no intervention. Results: No statistical or clinical differences were seen in any of the outcome measures. Conclusion: This preliminary data suggests that The Back Book may not be suitable to be used in isolation. Further research should establish the most appropriate point and mode of delivery of this information