Is there any way to predict recovery from back pain. This is my second episode of low back pain. The first time it only lasted five days. This time it’s been five weeks, and I’m still not better. What are the signs that I will get better?

The first step is to make sure you don’t have a serious medical condition. Have a physician examine you and rule out fractures, infection, or tumors. If you have a muscle strain or nonspecific low back pain (LBP), then you can proceed with a plan for recovery.

Be aware that psychologic factors play an important role in recovery from back pain. Studies show that emotional distress such as anxiety and depression are powerful predictors of chronic pain and disability.

Emotional distress and fear-avoidance beliefs (FAB) both contribute to nonrecovery months after LBP begins. FAB is the avoidance of movement out of fear that it will trigger painful symptoms and/or cause reinjury. If you find yourself saying, “Oops I can’t do that, my back won’t let me” you may be magnifying your symptoms. Any of these behaviors can put you at risk for chronic pain and disability.

You’ll know you are getting better if you can do a little more each day. Keep track of movements and activities that are restricted right now. Little by little, try to resume each of those positions and motions. You can measure progress by seeing if you can do things this week that you couldn’t do last week or the week before.