The Fear of Back Pain

Fear of pain and avoiding activities is common with patients who have low back pain (LBP). A survey called the Fear Avoidance Beliefs Questionnaire (FABQ) can be used to see if patients' activities are controlled by their fears. In this study researchers looked to see if FABQ scores can predict the results of treatment with exercise.

All patients were from a Middle Eastern culture. Everyone was enrolled in a 10-week program of muscle strengthening. The low back muscles were the targeted area. No one was on worker's comp. In other words none of the patients were injured workers. All patients completed a strength test of the lumbar extension muscles before and after treatment.

The results of this study showed two things. First, expected pain and actual pain got better for patients who finished treatment. Second, the amount of actual pain was not as much as expected. Results were the same for men as for women.

The authors point out that using the FABQ for people who don't have worker's compensation may not be helpful in predicting outcome. If we rely on the FABQ results before treatment it would look like patients would fail to improve after treatment. Therapists can still use the FABQ to identify patients who have high pain expectations.



References: Saud M. Al-Obaidi, PhD, MCSP, PT, et al. The Relationship of Anticipated Pain and Fear Avoidance Beliefs to Outcome in Patients with Chronic Low Back Pain Who are Not Receiving Workers' Compensation. In Spine. Vol. 30. No. 9. Pp. 1051-1057.