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Fear avoidance behaviour impacts recovery after a lower back injury, especially if it’s not the first episode or the symptoms have been around longer than 2-3 months. This idea can also explain why someone may enter a chronic pain cycle and how important it is to undertake the best pain management strategies in the early stages of injury.

When someone hurts their back (or any other body part), a person can take one of two paths. The first one being continuing with their independence without negative thoughts, acceptance of the pain which leads to a faster recovery. The second option is after an injury, a person begins thinking in a catastrophizing way about their pain which can then lead to them avoiding movements or activities in fear. Unfortunately, this can lead to the pain getting worse and the threshold at which someone experiences pain in the future is lowered.

The Fear Avoidance Model

If you start to associate pain with a certain event, time, or something that you did, there is a high chance that you will start avoiding these things out of fear of experiencing a recurrence of this pain. By doing this you aren’t giving your body a chance to recover fully and become stronger and better equipped to deal with these events in the future. As an example, if you hurt your back while lifting a pot plant, alt. hough you may not be able to lift that weight for a few days following injury, it certainly doesn’t mean you should avoid lifting that pot plant in the future. Instead, your rehab will be based around adapting your body’s ability to perform this activity by improving the strength and endurance in the right muscle groups.

Good news is you can always break the cycle, the best thing to do is to adapt and train movement patterns that you have perhaps been avoiding in order to build the tolerance back up. This will instill confidence in you and your body’s ability to function.

Dan Ryles

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