PTOTCohortThe Journal of orthopaedic and sports physical therapy2021

Fear Avoidance Predicts Persistent Pain in Young Adults With Low Back Pain: A Prospective Study.

Jo Armour Smith, Lindsay Russo, Noel Santayana

PMID 33998262

WHAT IT FOUND

Fear avoidance and pain interference predicted persistent pain in young adults.

Most participants improved, but those with high fear avoidance stayed in moderate/high pain. Physical activity levels did not differ between groups, challenging the assumption that inactivity drives chronicity in this population.

Key findings

01Individuals in the persistent pain class were significantly more likely to have high fear avoidance scores at baseline.

02Participants with low back pain did not have lower physical activity levels than back-healthy controls.

03Three-quarters of young adults with low back pain experienced benign and improving pain intensity over time.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The cohort was homogenous, consisting of college students who were relatively socioeconomically advantaged. Women were over-represented in the sample. Treatment received by participants was not tracked or controlled. Participants were not asked to identify the exact anatomical location of their pain. The study was not powered to investigate acute pain trajectories following first episodes.

Declared interests

No specific conflicts of interest or funding sources were declared in the provided text.

The easy way to misread this

Do not conclude that increasing physical activity will resolve persistent pain in this population. The study found no difference in physical activity levels between those who improved and those with persistent pain, suggesting fear avoidance and pain interference are more relevant prognostic factors.

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