Fear-avoidance beliefs about back pain in patients with acute LBP

Objective: We aimed to assess fear-avoidance beliefs in patients with acute low back pain (LBP) and to identify features of patients and general practitioners (GPs) associated with patients' fear-avoidance beliefs. Methods: A cross-sectional study conducted in primary care practice in France. A total of 709 GPs completed a self-administered questionnaire assessing fear-avoidance beliefs [the Fear-Avoidance Beliefs Questionnaire (FABQ)] and 2727 patients with acute LBP completed a self-administered questionnaire assessing pain , perceived handicap and disability (on the Quebec Back Pain Disability Scale) and fear-avoidance beliefs (on the FABQ). Results: Patients' FABQ mean scores were 16.8 +/- 5.0 for physical activities (FABQ Physical) and 19.5 +/- 10.9 for occupational activities (FABQ Work). From multivariate analysis, the following factors were associated with patients' FABQ Phys and Work scores: having a GP with a high rating on the FABQ Phys (P = 0.0001 and 0.02 for FABQ Phys and Work, respectively), no sport practice (vs. occasional: P = 0.0003 and 0.03; vs. usual/ competition: P = 0.0001 and 0.004), disability score (Quebec) (P = 0.0001 for both FABQ scores), and pain intensity (P = 6.0012 and 0.0013). Conclusions: High levels of fear-avoidance beliefs occur early in LBP patients, and key messages on this topic should probably be delivered at a very early stage of the disease.