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Table 4 Statements by primary health care providers on psychosocial aspects as pain modulators

From: Misbeliefs about non-specific low back pain and attitudes towards treatment by primary care providers in Spain: a qualitative study

Subthemes

Quotations

The relationship between perceived pain intensity and mood

“With the same pathology, there is a lot of difference with a person with a depressed mood than with a good mood. I think it modulates the pain very much, at least the perception that the person has” (BM 1).

“A person who is positive, who is dynamic and who has things to do, greatly increases the pain threshold. And another one who is at home watching TV [...] Well, this one is going to notice the pain a lot more” (BM 3).

“Avoid stress, avoid all those conditions that are harmful or that you perceive as harmful [...] At times when more pain appears, have resources, drugs, whatever, to control those moments of increased pain” (BM 4).

“One will not endure one thing, and you see another (patient) who has the same thing and that one is tolerating it. He complains in another way. I do not know. It depends on the personalities of the patients [...] Because it gives you a psychic discomfort that worsens the physical one” (BM 5).

“I don’t know exactly. I do not know if it has to do with endorphins or what. But that the pain threshold is directly related to mood, I’m sure” (BM 4).

The influence of the environment on pain

“People who are working because they come for lumbago from time to time. When they retire, they are invalidated, they stop working or anything else because you have them more often because of lumbago [...] because as me have nothing else to do, I’m going to see the doctor to see what this is” (BM 3).