A prospective consecutive cohort study of patients with cervical spine pain and patients with lumbar spine pain referred to an academic medical center.
To investigate the presence of fear-avoidance beliefs in a sample of patients with cervical spine pain and to compare the association of pain intensity, disability, and fear-avoidance beliefs in patients with cervical spine pain with that in patients with lumbar spine pain.
Fear-avoidance beliefs are a specific psychosocial variable involved in the development of disability from low back pain. Psychosocial variables are believed to play a role in cervical disability, but specific variables have not been investigated.
Consecutive patients referred to a multidisciplinary center completed self-reports of disability, pain intensity, and fear-avoidance beliefs during an initial evaluation session. Gender, type of symptom onset, acuity, and payer source were also recorded. Associations between disability, pain intensity, and fear-avoidance beliefs were investigated in patients with cervical spine pain and patients with lumbar spine pain.
In all, 163 patients completed the self-reports and were included in this study. Weaker relations between fear-avoidance beliefs and disability were found in patients with cervical pain than in those with lumbar pain. Significant differences in fear-avoidance beliefs were found for gender, type of symptom onset, and payer source (workers’ compensation, auto insurance, and traditional insurance).
The associations among fear-avoidance beliefs, pain intensity, and disability differed between patients with cervical spine pain and patients with lumbar spine pain. Fear-avoidance beliefs were significantly different in subgroups of patients.
From the *School of Health and Rehabilitation Sciences, University of Pittsburgh, and
†Physical Therapy and Chiropractic Services Comprehensive Spine Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Acknowledgment date: June 29, 2000.
First revision date: September 1, 2000.
Second revision date: November 6, 2000.
Acceptance date: January 29, 2001.
Device status category: 1.
Conflict of interest category: 12.
Address correspondence to
Steven Z. George
6035 Forbes Tower
Pittsburgh, PA 15260