Introduction
Misconceptions about back pain are common among the general public and may drive disability, ineffective self-management, and low-value healthcare use. While individual beliefs have been described, a comprehensive overview of population-level beliefs and their measurement remains lacking. This scoping review aimed to map the prevalence, types, and assessment tools of back pain–related beliefs in population-based studies, and to identify key gaps in contemporary evidence.
Methods
Eligible studies used probabilistic sampling of the general population and quantitatively assessed the prevalence of different beliefs about back pain. Given the significant heterogeneity of belief used to measure the same underlying constructs, belief statements were grouped into domains using a conceptual framework informed by the biopsychosocial model and current clinical guidelines.
Results
Twelve studies (22,903 participants) from high-income countries were included. Ninety belief statements were identified across nine domains. A substantial proportion of the public endorsed misconceptions, including beliefs that back pain is caused by specific injuries (47.3 to 58.5%), requires rest (20.4 to 76.5%), usually needs healthcare (53.7 to 84.8%), and benefits from imaging (44.6 to 70.6%). Endorsement of evidence-consistent beliefs was generally low and varied widely across countries, particularly regarding activity (28.9 to 86.6%) and medication use (23.9 to 32.6%). Measurement tools varied widely and showed limited coverage of contemporary guideline-based care.
Discussion
Population-level misconceptions about back pain remain widespread and have been documented almost exclusively in high-income countries. This highlights a major evidence gap regarding public beliefs in diverse cultural and healthcare contexts, particularly in low- and middle-income countries. Existing measurement tools inadequately capture contemporary evidence on inappropriate care and appropriate healthcare-seeking. Future research should prioritise updated, validated instruments and expand population-based studies across settings. Effective population-level interventions will need to improve care and outcomes for people with back pain.