The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review
It is believed that psychological factors may affect the experience of pain in LBP patients. The theory being that in some individuals, negative beliefs about pain and/or illness information may lead to catastrophising. This may lead to fear and avoidance of activity. The result of this conduct results in distress and reinforcing the original negative judgment in a destructive circle.
This systematic review found convincing evidence that high fear and work beliefs in patients with subacute LBP are prognostic for poor work-related outcomes. However LBP less than 2 weeks or more than 3 months were less associated with poor work outcome. Both of the reviewed were prognostic in the subacute setting, but not in the chronic population. The reviewed scales could not be recommended over the other.
Recent research has shown several new questionnaires allow the identification of patients at risk developing fear avoidance and thereby identifying individuals who may benefit from risk-based treatment. Examples of these questionnaires are STarT Back Tool, Orebro questionnaire.
The review concludes that evidence suggests that fear avoidance beliefs are prognostic for poor outcome in patients with subacute LBP and should be addressed in this population to avoid delayed recovery. > From: Wertli et al., Spine J (2013) (Epub ahead of print). All rights reserved to Elsevier Inc.
Visit the Pubmed summary for more information or your article access.