Table 2.
Common beliefs about the body and pain.
| Beliefs | Generic | Specific (Back)26, 31, 43 | Specific (Knee)32, 55 | Specific (Hip)56 |
|---|---|---|---|---|
| IDENTITY (What is it?) | “Pain is a sign of damage” | “Slipped disc” “Degeneration” |
“Knee osteoarthritis is bone on bone.” | “Damaged hip structures” “Fissures and tears in the hip tendons” |
| CAUSAL (What causes it?) | “Bad posture; misuse; overuse; injury without being aware that was causing damage at the time.” | “Weak core” “Poor posture” “Bending and lifting” |
“Osteoarthritis is due to excessive loading through the knee.” | “Underlying structural abnormality” “A history of high-intensity sport” “Poor posture” |
| CONSEQUENCE (What are the consequences?) | “The body needs protecting, rest and avoidance to heal.” | “Back pain will become persistent and deteriorate in later life” “The back is vulnerable and will need protection in the future” |
“Fear of falling and damaging the joint.” | “You’ll never be able to do cardiovascular exercise again” |
| TIMELINE (How long will it last?) | “Pain gets worse with ageing” | “Back pain gets worse with ageing” | “Osteoarthritis is a downward trajectory” | “Unless the damaged can be fixed; the pain is here to stay” |
| TREATMENT (How can it be controlled?) | “Fixing or replacing the damaged structure.” | “There is no cure for back pain” | “Physiotherapy can’t help bone on bone” “A mechanical problem requires a mechanical fix.” |
“The labral tear needs to be knitted back together” “Eventually everyone with a hip like this needs a hip replacement” |