When It Comes to Back Pain, There's Nothing to Fear Except Fear ItselfA bout of low back pain (LBP) can start a vicious cycle. Fear of pain and further injury can make people avoid activity. Avoiding activity can make people depressed. It can also make the pain last longer. More depression and pain can lead to even more fear. And so the cycle goes around again.
It has been assumed that the cycle of fear and LBP leads to disability and low levels of fitness. This Dutch study tested patients with chronic LBP to see if that is true. Patients answered questions to rate their fear, depression, and disability levels. Their aerobic fitness and body fat percentages were tested. The authors then looked for relationships between fear levels, fitness, and disability.
There were some interesting results:
This study had limitations. It didn't test many subjects. The authors also note that it might be important to check differences in each individual's fitness levels before and after the LBP started. Still, the results suggest that doctors and therapists shouldn't assume that people who are afraid of their LBP will become less fit.
Jeanine A. Verbunt, MD, et al. Fear of Injury and Physical Deconditioning in Patients with Chronic Low Back Pain. In Archives of Physical Medicine and Rehabilitation. August 2003. Vol. 84. No. 8. Pp. 1227-1232.
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