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Emotional Distress Linked to Chronic Low Back Pain

In recent years researchers have discovered that fear-avoidance beliefs (FAB) are linked with chronic low back pain (LBP) and disability. FAB is observed in LBP patients who alter the way they move out of fear that movement will hurt. Two types of FAB have been identified. One is linked with general physical activity. The other is work-related.

In this study, the impact of emotional distress is measured and compared to FAB. Emotional distress included anxiety, depression, and somatization. Somatization is the process of expressing emotional distress as physical symptoms. Somatic symptoms often include headaches, neck or back pain, and joint or muscle aches and pains.

Two groups of patients were included. Group A had acute LBP (lasting less than three weeks). Group B had chronic LBP, which was present for more than three months.

Everyone was given tests of function and a FAB survey. Acute patients were reexamined after four weeks. Chronic LBP patients were given the same testing after three months. All patients in both groups were followed at regular intervals until the end of 12 months.

The authors report the following findings:
  • FAB was greater for work-related activities than for general physical activities
  • FAB for physical activity decreased in the acute group but stayed the same for
    the chronic group
  • Distress was a stronger predictor of disability compared to FAB after 12 months
  • Smoking was a greater factor than FAB in predicting pain intensity

    The authors suggest that emotional distress and FAB may not be separate. Both may be linked to chronic back pain. Distress may be a greater predictor of disability than FAB. More study is needed to identify which factors best predict who will go from acute to chronic pain and disability. Finding ways to prevent this process is the final goal.


    Margreth Grotle, PhD, et al. Clinical Course and Impact of Fear-Avoidance Beliefs in Low Back Pain. In Spine. August 15, 2006. Vol. 31. No. 9. Pp. 1038-1046.

    09/21/2006

    *Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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