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Fear More Than Pain Predicts Outcome in Low Back Pain

Posted on: 02/24/2006
Some low back patients with acute pain don't get better. They become chronic pain patients. This study shows how the fear of pain more than the pain itself actually predicts who will transition from acute to chronic low back pain (LBP). And fear that is linked with pain is also linked with restricted physical movement. In the end the acute LBP patient sees himself as more disabled than he really is based on pain-related fear.

The authors came to these conclusions by studying 96 men and women with acute LBP. Each one lifted a 15- pound bag from the floor to a table. Then the bag was lifted off the table and set on the floor again. The number of times the bag was lifted and the total lifting time were recorded. The authors make note of the fact that the average adult would not have any trouble lifting 15 pounds repeatedly. But someone with back pain may feel threatened by the task.

Before starting the lifting task each person filled out several forms. The surveys asked questions about age, gender, and education level. There were questions about activity level and pain intensity. Fear of movement or reinjury was also assessed from a separate test.

If the results of this study show that pain-related fear will lead to actual disability, what can be done about it? The authors suggest two things. First, use a screening tool to identify patients with pain-related fears. Then give the patient information to reduce fear and prevent disability. The goal is to keep acute low back pain patients from becoming chronic back pain patients.

References:
Ilse E. J. Swinkels-Meewisse, et al. Acute Low Back Pain: Pain-Related Fear and Pain Catastrophizing Influence Physical Performance and Perceived Disability. In Pain. January 2006. Vol. 120. Issues 1-2. Pp. 36-43.

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