ArticleThe role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work statusFritz, Julie M.a,*; George, Steven Z.b; Delitto, AnthonycAuthor Information aDepartment of Physical Therapy, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260, USA bSchool of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA cDepartment of Physical Therapy, University of Pittsburgh, Director of Education and Research, Centers for Rehab Services, Pittsburgh, PA, USA *Corresponding author. Tel.: +1-412-383-3365; fax: +1-412-383-6629 E-mail: [email protected] Received 15 May 2000; received in revised form 14 March 2001; accepted 2 May 2001. Pain: October 2001 - Volume 94 - Issue 1 - p 7-15 doi: 10.1016/S0304-3959(01)00333-5 Buy Metrics Abstract Fear-avoidance beliefs have been identified as an important psychosocial variable in patients with chronic disability doe to low back pain. The importance of fear-avoidance beliefs for individuals with acute low back pain has not been explored. Seventy-eight subjects with work-related low back pain of less than 3 weeks'duration were studied. Measurements of pain intensity, physical impairment, disability, nonorganic signs and symptoms, and depression were taken at the initial evaluation. Fear-avoidance beliefs were measured with the work and physical activity subscales of the Fear-avoidance Beliefs Questionnaire. Disability and work status were re-assessed after 4 weeks of physical therapy. Patterns of correlation between fear-avoidance beliefs and other concurrently-measured variables were similar to those reported in patients with chronic low back pain. Fear-avoidance beliefs did not explain a significant amount of the variability in initial disability levels after controlling for pain intensity and physical impairment. Fear-avoidance beliefs about work were significant predictors of 4-week disability and work status even after controlling for initial levels of pain intensity, physical impairment, and disability, and the type of therapy received. Fear-avoidance beliefs are present in patients with acute low back pain, and may be an important factor in explaining the transition from acute to chronic conditions. Screening for fear-avoidance beliefs may be useful for identifying patients at risk of prolonged disability and work absence. © 2001 Lippincott Williams & Wilkins, Inc.