Background: There are well-established positive relationships between psychological distress and chronic back pain and disability. However, there is very limited research in relation to levels of psychological distress and the effect it has on treatment engagement in those with chronic back pain.

Methods: 89 men and 112 women experiencing back pain recruited via convenience sampling completed the Depression, Anxiety and Stress Scale, Oswestry Low Back Pain Disability Questionnaire, the West Haven-Tale Multidimensional Pain Inventory, and a demographic questionnaire designed purposely for the study.

Results: Depression, anxiety, affective distress, and life control predicted the number of treatments engaged in for back pain, (R² = 0.29, [16,161] = 12.19, p = .0005) and the level of disability, (R² =.31, F[14,177] = 19.60, p = .0005).

Conclusions: The level of engagement in treatments was predicted by psychological factors rather than by the level of pain experienced by participants. The findings showed that participants who were psychologically distressed, not only had higher levels of pain and disability, but also engaged in fewer treatments.

450 self-addressed, reply-paid, envelopes containing the participant information, consent form and the battery of questionnaires were distributed through doctors and allied health professionals.  Health professionals consented to be part of the recruitment process by signing and returning a consent form.  The project was approved the Victoria University Human Ethics Committee (HRETH 08/282).  The data collected in the questionnaire were analysed utilizing the Statistical Program for Social Sciences Version 22 (SPSS).  The response rate was 201/450 = 44.66%. Each participant signed a consent form after reading a letter of invitation to participate with information about the research as well as contingency strategies in the case of any psychological disturbance as a result to their involvement in this study. The data collected from the questionnaires were input reflecting the participants’ answers and questionnaires were scored according to the guidelines recommended by the original authors of each questionnaires.