Whether or not to take medication for back pain depends more on the impact felt by the patient than on health knowledge. This is what a study conducted by researchers from CINTESIS@RISE/Faculty of Medicine of the University of Porto (FMUP) reveals.
Low back pain is highly prevalent, affecting an estimated 26.4% of the Portuguese population acutely and usually disappearing within six to eight weeks. Although the prognosis is usually good, it often causes loss of mobility, functionality, and quality of life.
The medication used, which includes painkillers and muscle relaxers, helps to relieve and control the pain. However, it is known that around half of patients do not seek help from a doctor.
The study has been published in Family Medicine & Primary Care Review. It applied questionnaires to 249 participants, 41% of whom reported taking pain medication, mainly non-steroidal anti-inflammatory drugs (85%). Only 16.1% used physiotherapy and 24.1% used alternative therapies. Among the patients who used medication, adherence to treatment was 84.4%.
More than half of the participants had experienced low back pain in the previous month. Most (63.1%) could identify a movement or position that was causing the pain. Around 32% considered their pain to be severe. As expected, 47.4% said that the pain had a significant impact on their activities of daily living, causing serious limitations in 2.8%.
“The main factor associated with adherence to medication was the impact of pain on daily life, including the duration and intensity of pain. The perception of the impact of pain is more relevant to taking medication than literacy or individual beliefs,” explain the authors Ana Luísa Amorim and Paulo Santos, from CINTESIS@RISE and FMUP.
According to the researchers, these results can be explained, in part, by the fact that medication for acute pain has a clear benefit for the patient, unlike in chronic illnesses, where “it is necessary to educate patients about the benefits of treatment or where there are beliefs and fears about potential side effects”.
In this model of acute illness, access to appropriate treatment is more relevant than continuing education and literacy, although there needs to be some caution when extrapolating these results to the general population, as these participants were younger, had fewer associated illnesses and were more health literate.
This study is the first to analyze the relationship between health literacy and medication adherence in low back pain, as a model of acute illness.