Does Fear Predict the Future of Low Back Pain?

Low back pain (LBP) has become so common in today's culture that many more studies are being done on the topic. Fear of movement and fear that the person will hurt him or herself again is also common. Studies show that pain-related fear is often present early in a patient with LBP. Does it predict future disability? That's the topic of this study.

Over 500 adults ages 18 to 65 with acute LBP were studied for a period of six months. Each patient was asked a series of questions before and after treatment. The survey included questions about the patient's pain, function, and beliefs about movement and activity.

The authors report that fear of movement/(re)injury is linked with future disability. The study also showed that other factors such as age, pain intensity, and pain duration can also predict outcomes. Other findings included:

  • Level of education was linked with participation but not disability. Patients with more education were more likely to stay active in work and social activities despite LBP.
  • Fear of harm develops early in patients with LBP.
  • LBP doesn't always go away on its own.

    This study confirms previous research that suggests prognosis of LBP depends on many factors. Fear of movement/reinjury is the most powerful predictor. Current treatment advising patients to stay active may not be helpful for someone with high levels of pain-related fear. The authors suggest a program of fear-reduction education and a behavioral approach to LBP with counseling.



    References: Ilse E. J. Swinkels-Meewisse, MSc, et al. Fear of Movement/(Re)Injury Predicting Chronic Disabling Low Back Pain: A Prospective Inception Cohort Study. In Spine. March 15, 2006. Vol. 31. No. 6. Pp. 658-664.

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