Factors associated with fear-avoidance beliefs about low back pain

Low back pain (LBP) is a common major health problem. Fear-avoidance beliefs are thought to be an important risk factor for chronic LBP. This study investigated factors associated with the Fear-Avoidance Beliefs Questionnaire (FABQ) scores of Japanese adults who experienced LBP. We focused on the association of FABQ scores with medical advice to rest and the experience of seeing family members and/or significant others with disabling LBP.

In February 2011, 1,063,083 adults aged 20-79 years who had registered as internet-based research volunteers were randomly selected and invited to participate in a questionnaire survey. The data from 52,650 respondents who had experienced LBP were analyzed. Multiple linear regression analysis was used to examine the association between FABQ physical activity scores and the advice for respondents with LBP to rest, the experience of seeing others with disabling LBP, and other personal and LBP factors.

After controlling for age, sex, and lifetime and current LBP disability grades, the experience of seeing others with disabling LBP (regression coefficient β = 0.94), rest advice (β = 0.91), history of chronic LBP (β = 0.78), radiating pain below the knee (β = 0.44), and workers' compensation (β = 0.51) were associated with higher FABQ physical activity scores. Conversely, regular exercise (β = -0.89) and LBP attributed to sports (β = -0.76) were associated with lower FABQ physical activity scores.

The association between rest advice and higher fear-avoidance beliefs supports the recent treatment guidelines that emphasize continuation of daily activities.

cross-sectional study.