Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain: An assessment of health literacy

Thirty-six community-dwelling adults with CLBP and 44 with no history of LBP responded to the HeLMS. Individuals were recruited as part of a larger community-based spinal health study in Western Australia. Scores for the eight domains of the HeLMS as well as individual item responses were compared between the groups.HeLMS scores were similar between individuals with and without CLBP for seven of the eight health literacy domains (p > 0.05). However, compared to individuals with no history of LBP, those with CLBP had a significantly lower score in the domain 'Patient attitudes towards their health' (mean difference [95% CI]: 0.46 [0.11-0.82]) and significantly lower scores for each of the individual items within this domain (p < 0.05). Moderate effect sizes ranged from d = 0.47-0.65.Although no differences were identified in HeLMS scores between the groups for seven of the health literacy domains, adults with CLBP reported greater difficulty in engaging in general positive health behaviours. This aspect of health literacy suggests that self-management support initiatives may benefit individuals with CLBP.Low back pain (LBP) represents a major public health issue globally [1]. Despite the vast majority of individuals experiencing LBP at some point in their lives, only a modest proportion experience chronic LBP (CLBP) with ongoing disability [2,3]. Nonetheless, this subgroup consumes the majority of health resources related to spinal pain [4,5], highlighting an urgency to identify modifiable risk factors for chronicity and disability related to LBP, and to optimise the delivery of treatment approaches and health information for consumers and health providers [5]. Although a large volume of research has been undertaken to test the efficacy of treatment approaches for CLBP, only modest treatment effects have been observed and health expenditure continues to soar [6,7]. This trend may suggest that potentially important mediating factors are being overlooked. Health litera