I went to see a physical therapist for chronic low back pain. There were several tests I had never done before. For example, the therapist asked me to count backwards by threes while she lifted my leg off the table. Then she tested my knee and ankle reflexes in two different positions. What are these tests for?

Some patients change the way they think about moving after having back pain for a long time. When a patient tells the therapist, “Oh, I can’t do that … my back won’t let me,” it’s a sign of behavioral responses to the pain. In these cases, some special tests are needed. Such tests help point out when and how much a patient’s behavior has changed as a result of the back pain.

Treatment for chronic back pain tries to reduce the painful symptoms, but also increase function. Changing the way the patient thinks about the pain is an important part of this process.