Chronic Pain, Distress and Illness Behavior

  • Chris J. Main
  • Gordon Waddell


At least one out of every two people in western society suffers from back trouble at some time in their life. Along with respiratory disease, heart trouble and arthritis or rheumatism, backache is one of the commonest causes of morbidity, disability and perceived threat to health, particularly in the most active middle years of life (Rowe, 1969; Benn and Wood, 1975; Wood, 1976; DHSS, 1979). In the United Kingdom, backache causes more time off work than strikes and each year some 12 million working days are lost by a third of a million people with backache. 1.1 million patients consult their family doctor, 0.3 million are referred to hospital out-patient departments, 30,000 are admitted to hospital and 5,000 have an operation on their back. Between 20 and 35% of all new orthopaedic referrals concern backache. Cumulatively there are 80,000 people in the United Kingdom (about 0.015%) permanently disabled by backache and arguably the worst back cripples result from the 10–15% of operations which fail and lead to repeated back surgery (Waddell et al, 1979). In North America, the chances of an individual coming to back surgery are six times greater than in Europe (Kane, 1980). The total annual cost of backache in Britain is at least £320 million and on a world scale, the annual toll of backache includes many billions of dollars and some quarter of a million operations, yet many millions of people remain disabled. Paradoxically, despite the efforts of modern medicine, the problem appears greatest in the quarter of the world’s population living in western ‘civilisation’, while the rest of mankind seems to cope with backache despite an almost total lack of social security, technologically orientated medicine or back surgery.


Chronic Pain Depressed Mood Physical Impairment Pain Tolerance Minnesota Multiphasic Personality Inventory 
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Copyright information

© Plenum Press, New York 1982

Authors and Affiliations

  • Chris J. Main
    • 1
  • Gordon Waddell
    • 2
  1. 1.Psychology DepartmentGartnavel Royal HospitalGlasgowScotland
  2. 2.University Department of Orthopaedic SurgeryGlasgowScotland

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