Does Having a Fear of Movement Change the Benefits of Physical Therapy for Those With Sciatic Back Pain?


Sciatica or a radiating leg pain from low back issues is a common and uncomfortable physical problem. Studies indicate it can happen in up to 34 percent of adults each year. The good news is that it usually improves with time. Unfortunately, sciatic back pain has significant negative medical, financial, social, and work-related impacts. This type of injury tends to take longer to get better and is often more disabling as it hurts to move. Recent reviews of the research state that there is not enough evidence to make a recommendation for or against using Physical Therapy (PT) or a structured exercise program for people with this back and leg pain condition.

This study aimed to investigate whether patients with kinesiophobia (fear of movement) improved any more with PT and general practitioner advice (intervention group) compared to receiving care from their general practitioner (control group) on returning to normal movement and medication alone.

135 patients with acute sciatic qualified for this study and were randomly assigned to either the control or intervention group. These groups were again divided into high or low kinesiophobia groups based on surveys and their exam results. Each group was assessed at three months and one year following their treatments.

The results found that patients with high levels of initial fear of movement due to their radiating leg / sciatic back pain benefited more from PT considering their significantly improved measures of reduced leg pain one year following their treatment. At three months after the start of their pain episode, 68 percent of the patients reported improvements in recovery from their sciatic condition (73 percent of which were in the intervention group and 63 percent were in the control group).

One year after the start of their pain episode, 73 percent of the patients reported significant improvements towards complete recovery (82 percent of which were in the intervention group and 63 percent were in the control group).

Researchers in this study were surprised that patients randomly assigned to the PT intervention group did not show more improvements at the three month follow up, as this is when they were getting their most intensive treatments. This study concluded that in this rather small sample population of persons with sciatica, there is good evidence to support that the higher the level of kinesiophobia and pain initially, the better the chance they will benefit from decreased leg pain intensity after their Physical Therapy and general practitioner intervention at the one year follow up.