My buddy and I are both emergency medical technicians (EMTs). We also both hurt our back while on-the-job. Medical testing didn’t show any real injury, so we were released back to work. I’m doing okay but he seems to believe something serious is wrong with him. He can’t do half of what he could do before the injury. How do I help this guy get over the mental hump here?

Your fellow EMT may need additional testing to sort out what’s going on. It’s entirely possible there is some underlying serious pathology present that wasn’t detected early on. A medical doctor should be consulted for this. Perhaps a follow-up visit with the evaluating physician is in order.

In some states, Worker’s Compensation requires regular re-evaluation by an occupational health physician. If you do not have this in your state, then returning to the original physician may be a good idea for your partner. Or your co-worker may want to seek a second opinion with a separate, independent doctor.

Another possibility is that your partner is exhibiting fear-avoidance behaviors (FABs). Studies show that psychologic factors can lead to the belief that certain movements will always cause pain or reinjury. Such beliefs lead the person to avoid movement that can actually cause a continued cycle of chronic pain and disability.

An occupational or physical therapist can test for FABs. A special questionnaire called the FABQ is used. The FABQ has two main sections: one on avoidance of general physical activity and one related to work activity. If a person scores high on the test, the therapist can provide a program to work through this.