Do Teaching General Practitioners' Fear-Avoidance Beliefs Influence Their Management of Patients with Low Back Pain?

Objectives: To describe fear-avoidance beliefs about low back pain (LBP) in a sample of teaching general practitioners (TGPs) and to investigate the impact on following the guidelines for LBP.

Methods: A sample of 112 French TGPs were contacted to complete a self-administered questionnaire including socio-demographic and professional data, personal history of LBP, CME about LBP and usual practices, and their low back pain beliefs using the Fear-Avoidance Beliefs Questionnaire (FABQ) and the Back Belief Questionnaire (BBQ).

Results: Forty-seven responded, 48% treated more than 10 LBP patients per month, and 45% participated in an educational session on LBP during the previous 3 years. Seventy percent reported a previous episode of acute LBP, while 30% suffered from chronic LBP. The median scores for the FABQ-phys and work were 8 (4 to 10) and 17 (11 to 21), and 35 (31 to 38) for the BBQ. There were no correlations between age or years of practice and FABQ scores. TGPs suffering more than 1 acute LBP episode per month had a lower BBQ score (P < 0.05). Those prescribing more imaging exams in acute LBP had higher FABQ and lower BBQ scores, while those who recommended rest in both acute and chronic LBP had a higher FABQ-phys score.

Discussion: Teaching general practitioners' fear-avoidance beliefs about LBP are lower than previously reported by their GP colleagues but still negatively influence the way they follow guidelines for LBP patients. This may influence the way they teach the management of LBP.