Activity avoidance and function in persons with chronic back pain

This study examined the relative contribution of two aspects of pain-relate d fear to functional disability among 133 persons with chronic pain, predom inantly chronic back pain: 1) beliefs that pain represents damage or signif icant harm to the body and 2) beliefs that activities that cause pain shoul d be avoided. Pain-related fear was assessed using the Tampa Scale for Kine siophobia, Version 2 (TSK-2). Factor analysis in the present study replicat ed the two-factor solution found in a previous investigation, representing the two dimensions of pain-related fear noted above. Activity avoidance was significantly associated with the percent of maximum expected weight lifte d from floor to waist and waist to shoulder during Progressive Isoinertial Lifting Evaluation (PILE). Fear of damage or harm to the body was only sign ificantly related to the floor to waist lift When controlling for demograph ic, physiologic, and other psychological variables, only activity avoidance continued to significantly predict performance on both lifts of the PILE. Although it has been proposed that deconditioning may mediate the relations hip between activity avoidance and disability this was not supported in the present investigation The results highlight the importance of pain-related fear; particularly activity avoidance, in the assessment of functional act ivity among persons with chronic pain.