Community survey of factors associated with consultation for low back pain

Objective To investigate the psychosocial factors associated with consultat ion for low back pain. Design Two phase cross sectional postal survey. Setting Bradford Metropolitan Health District. Subjects 1813 adults responding to the phase 1 questionnaire. 540 of the 78 2 with an episode of low back pain in the past 12 months completed the seco nd questionnaire. Main outcome measures Six psychosocial constructs. Results 406 (52%) of the respondents reporting back pain in the past 12 mon ths had not consulted a health professional. Logistic regression showed tha t consultation was associated with externalised beliefs regarding pain mana gement (odds ratio 3.6; 95% confidence interval 2.1 to 6.0). Duration of pa in affected the factors associated with consultation Consultation for episo des lasting less than two weeks (n = 290) was associated with greater than median pain (3.0; 1.7 to 5.5), consultation for episodes over two weeks (n = 243) was associated with increased disability (3.7; 1.5 to 9.0), and cons ultation for episodes over three months (n = 143) with increased depression (3.9; 1.3 to 11.8). Conclusions The results support a role for psychosocial factors in consulta tion for low back pain and suggest that the reasons for consultation vary w ith duration of pain. Duration of the episode may be a useful guide to mana gement of non-specific low back pain.