What do the general public believe about back pain? A scoping review of population-based studies

Misconceptions about back pain are reported to be common among the general public. We aimed to identify evidence and gaps regarding the general public’s beliefs about back pain from population-based studies across the world. We systematically searched CINAHL, CENTRAL, Embase, Medline, PsycINFO, and Web of Science from inception until September 9, 2024 to identify population-based studies that quantitatively assessed beliefs about back pain. Twelve studies involving 22,903 participants from Australasia, Europe, North America, and the United Kingdom were included. These studies utilised five questionnaires and 27 study-specific statements to assess beliefs. Included studies investigated 90 discrete belief statements. A substantial proportion of the general public hold incorrect beliefs including that most back pain is caused by specific conditions or injuries (47.3%–58.5%), back pain rarely resolves (39.8%–74.2%), rest is helpful for recovery (20.4%–76.5%), staying active is unsafe or unhelpful (13.4%–71.1%), healthcare is always needed (53.7%–84.8%), imaging is usually informative (44.6%–70.6%), and simple painkillers are usually insufficient (67.4%–76.1%). Research investigating population-level beliefs about back pain has to date been restricted to high-income countries. Most included studies focused on beliefs about imaging and self-care, with limited attention to contemporary issues such as unsafe or unproven care and indicators to seek healthcare for back pain. Given the potential for incorrect beliefs to worsen outcomes for back pain, our findings underscore the need for improved measurement tools, tailored interventions, and policies that consider widespread misconceptions.