Pain-related fear predicts reduced spinal motion following experimental back injury

Pain. 2012 May;153(5):1015-1021. doi: 10.1016/j.pain.2012.02.001. Epub 2012 Feb 28.


The current study examined the prospective relationship between pain-related fear and altered motor behavior, as well as perceived interference, among 51 healthy participants following induction of delayed-onset muscle soreness (DOMS) to the trunk extensor muscles. Healthy participants without history of back pain completed standardized reaches to high and low targets at self-paced and rapid speeds before and after induction of acute low back pain using a DOMS paradigm. Pain-related fear was assessed prior to DOMS induction. Three-dimensional joint motions of the thoracic spine, lumbar spine, and hip were recorded using an electromagnetic tracking device. DOMS-induced differences between high- and low-fear participants were observed for lumbar spine flexion, but not for thoracic or hip flexion. Pain-related fear scores were not predictive of lumbar flexion during baseline, but predicted reduced lumbar flexion during self- and fast-paced trials to low target locations once DOMS was induced. Pain-related fear was likewise predictive of perceived interference in life activities following DOMS induction. The findings suggest that initially pain-free individuals with high pain-related fear adopt avoidant spinal strategies during common reaching movements shortly after injury is sustained, which may comprise a risk factor for future pain and disability.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Back Injuries / physiopathology
  • Back Injuries / psychology
  • Back Pain / physiopathology
  • Back Pain / psychology*
  • Fear / physiology
  • Fear / psychology*
  • Female
  • Hip / physiopathology*
  • Humans
  • Male
  • Movement / physiology
  • Muscle, Skeletal / physiopathology*
  • Pain Measurement
  • Range of Motion, Articular / physiology*
  • Spine / physiopathology*
  • Young Adult