ALTERING BELIEFS ABOUT PAIN AND IMPAIRMENT IN A FUNCTIONALLY ORIENTEDTREATMENT PROGRAM FOR CHRONIC LOW-BACK-PAIN

Objective: This study examined pain and impairment beliefs [measured w ith the Pain and Impairment Relationship Scale, (PAIRS)] of chronic lo w back pain patients during rehabilitation and hypothesized that pain beliefs would be stronger in drop-out subjects, decrease during treatm ent, and after treatment correlate strongly with disability measures. Design: Prospective cohort. Setting: Outpatient, functionally oriented rehabilitation program for chronic low back pain. Patients: 72 consec utive chronic low back pain referral patients disabled from working be cause of pain. Involvement: Interdisciplinary rehabilitation with a fo cus on intensive physical reconditioning was employed. Outcome Measure s: Program completion versus drop-out groups and pretreatment and post treatment pain, disability, depression, and PAIRS scores were compared . Results: Thirty patients dropped out and 42 subjects completed treat ment. The PAIRS scores at evaluation were similar for both groups. The PAIRS scores improved significantly during treatment (p < 0.001). Pos ttreatment PAIRS scores correlated highly with disability measures (r = 0.79, p < 0.001). Conclusion: Pain beliefs are of minimal value for predicting treatment compliance, but may be altered during functionall y oriented treatment of chronic low back pain. Posttreatment disabilit y closely mirrored attitudes and belief-associated pain and impairment .