Fear of movement/(re)injury predicting chronic disabling low back pain: a prospective inception cohort study

Study Design. Prospective inception cohort study. Objective. To investigate prospectively whether pain-related fear predicts future perceived disability and participation in patients with acute low back pain (LBP). Summary of Background Data. There are indications that fear of movement/(re) injury, as measured by the Tampa Scale for Kinesiophobia, is present early in an episode of LBP, and that it might be a predictor of future perceived disability and participation. Methods. A cohort of 555 patients with acute LBP included by general practitioners and physical therapists in primary care settings was followed for 6 months. Results. Results indicate that baseline fear of movement/(re) injury was predictive of future perceived disability and, to a lesser extent (and together with duration and radiation), of participation. Conclusions. The results suggest that interventions aimed at reducing pain-related fear in the acute stage of LBP might prevent restrictions of activity and participation because of pain, and might be a way of preventing the transition from acute to chronic LBP.