Negative back beliefs are associated with increased odds of low back pain and disability: a 10-year cohort study in men

Objective
Although negative back beliefs are associated with high-intensity low back pain (LBP)/disability, whether they influence incident high-intensity LBP/high disability over the long-term is unknown. This study aimed to investigate whether negative back beliefs were associated with developing high-intensity LBP and/or high disability over 10 years in men.
Methods
Men with no or low-intensity LBP and/or disability attending the Geelong Osteoporosis Study between 2006 and 2010 were included. Data on age, body mass index, mobility, education, back beliefs (Back Beliefs Questionnaire), LBP and disability (Graded Chronic Pain Scale) were collected between 2006 and 2010. Beliefs, LBP and disability were re-assessed in 2016–2021. Binary logistic regression was used to examine the association between negative back beliefs and incident high-intensity pain and/or high disability, adjusting for age, body mass index, mobility and education.
Results
At baseline, 705 participants (mean age 53.8 years) had no or low LBP and no or low disability; 441 (62.6%) participants completed a 10-year follow-up. Of these, 37 (8.4%) developed high-intensity pain and/or high disability. In multivariate analyses, participants with more negative back beliefs at baseline were more likely to develop high-intensity pain and/or high disability (odds ratio 1.05; 95% CI: 1.00, 1.11). Developing more negative back beliefs was also associated with incident high-intensity pain and/or high disability (odds ratio 1.20; 95% CI: 1.12, 1.30).
Conclusion
In a male community-based population, negative beliefs regarding the consequences of LBP were associated with an increased likelihood of developing high-intensity pain and/or high disability. Addressing negative back beliefs in the community may reduce the incidence of high-intensity pain and/or high disability over 10 years in men.