Why do some people with back pain recover while others go on to have chronic pain?

This is a complex question with many possible answers. Some of the answers have to do with the physical nature of the condition or injury. But many researchers believe that "psychosocial" factors may be equally or even more important when it comes to recovering from back pain.

For example, patients' fear of pain may affect their recovery. Patients' response to pain ranges from confrontation to avoidance. With confrontation, patients gradually return to their regular activities after an injury. This is seen as a healthy response. At the other end of the spectrum, patients avoid activities they think will cause pain. This can lead to exaggerated notions of pain and increased disability over time.

Fear of activities that may cause pain has been linked to disability and loss of work in patients with low back pain. Fear of activities seems to play less of a role in other kinds of spinal pain, such as neck pain. Different kinds of back pain present unique issues for both treatment and recovery. These issues need to be dealt with on an individual basis to get the best results for each patient.