15Pain beliefs are patients own ideas about their pain and what it means for them. These beliefs may range from very general idea to very specific. Illness beliefs provide us with a framework to make sense of how we are going to deal with pain. They influence our decisions about health care and whether or not we should be off sick from work. These beliefs are often inconsistent and contradictory and can often be difficult to change.

There appears to be four main aspects to a patient’s beliefs about illness.

  • The nature of the illness – beliefs about the cause and meaning of the illness and symptoms
  • The future course of the illness i.e. duration and outcome
  • The consequences of that illness on the patient’s life and work
  • Cure or control – beliefs about the expectations and personal responsibility associated with treatment of the illness

Patients can be concerned not only with the damage that may have already occurred, but also about the risk of further damage in the future. This negative belief that their backs may be vulnerable and prone to further injury can limit their ability to take control and personal responsibility of their pain. This in turn may affect their attitude towards rehabilitation and return to work.