I’ve been going to a special pain clinic to help me get better from my chronic back pain. I took a bunch of tests on paper and answered a lot of questions. The results say I just made the cut off for having the normal amount of fear. They say I’m not avoiding movement out of fear of pain like some people do. How in the world do they decide what the magic cut off number is? Can one number really make the difference between normal and not-so-normal?

You may have taken the Fear Avoidance Behavior Questionnaire (FABQ). This survey is a tool to help doctors and physical therapists identify patients who are afraid to move normally. Either fear of pain or fear of reinjury rules how or when they move.

There are really no known cut-off scores for this test. Studies done on back pain patients have given us a range of expected values. Some researchers group FABQ scores into high and low based on the physical activity scale in the test. The total score for that section is 24 points. Getting less than 15 is a low score. It means there’s a low risk for elevated fear-avoidance beliefs. More than 15 is high and signals a high level of fear-avoidance.

As you say the difference of one or two points doesn’t make sense. It may be best to look at the scores as being somewhere on the same line rather than dividing them into low or high.