Fear-avoidance beliefs and pain coping strategies in relation to lower back problems in a South African steel industry

Eur J Pain. 2006 Apr;10(3):233-9. doi: 10.1016/j.ejpain.2005.03.012.


The objective was to determine the association between the prevalence of lower back problems (LBP), fear-avoidance beliefs and pain coping strategies using an analytical cross-sectional epidemiological study among a group of 366 workers in a South African stainless steel industry. Outcome (LBP) was defined using a questionnaire and a functional rating index. Exposure to psychosocial risk was determined using the Fear-Avoidance Beliefs (FABQ) and Coping Strategies (CSQ) questionnaires. Multivariate logistic regression analyses for LBP indicated the following significant risk factors: work-related fear-avoidance beliefs (OR 3.40; 95% CI 2.20-5.25), catastrophizing (1.31; 1.01-1.7) and pain coping self statements (1.47; 1.16-1.87). Significant protective associations were found for increased activity levels (OR 0.57; 95% CI 0.42-0.78). These findings have utility in preventative screening procedures to identify workers with such beliefs and coping strategies who are at risk for prolonged work restrictions.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Avoidance Learning*
  • Fear*
  • Female
  • Humans
  • Low Back Pain / epidemiology
  • Low Back Pain / psychology*
  • Male
  • Metallurgy*
  • Occupational Diseases / epidemiology
  • Occupational Diseases / psychology*
  • Prevalence
  • South Africa
  • Steel


  • Steel