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Effects of Education on Return-to-Work Status for People With Fear-Avoidance Beliefs and Acute Low Back Pain

JJ Godges, PT, DPT, OCS, is Coordinator, Clinical Education and Practice, Optimum Care Providers, 200 Mantua Rd, Pacific Palisades, CA 90272 (USA).
MA Anger, PT, DPTSc, is Occupational Health Physical Therapist, US Healthworks Medical Group, Ontario, Calif.
G Zimmerman, PhD, is Associate Dean, Research, School of Applied Health Professions, Loma Linda University, Loma Linda, Calif.
A Delitto, PT, PhD, FAPTA, is Professor and Chair, Department of Physical Therapy, and Director of Research, Comprehensive Spine Center, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pa.

jgodges{at}ptholdings.com

Background and Purpose: People with acute low back injury and fear-avoidance beliefs are at risk for remaining off work for an extended period of time. However, the effectiveness of intervention strategies for improving return-to-work status in people with acute low back pain and fear-avoidance beliefs has not been reported. The objective of this study was to determine whether education and counseling on pain management, physical activity, and exercise could significantly decrease the number of days that people with low back injury are off work.

Subjects: Thirty-four people who were unable to return to work following a work-related episode of low back pain and who exhibited fear-avoidance beliefs participated in this study.

Methods: Participants who scored 50 points or higher on the Fear-Avoidance Beliefs Questionnaire were alternately assigned to an education group or a comparison group. Both groups received conventional physical therapy intervention. Participants in the education group were given education and counseling on pain management tactics and the value of physical activity and exercise. The effectiveness of the interventions was measured by the number of days before people returned to work without restrictions.

Results: All participants in the education group returned to regular work duties within 45 days. One third of the participants in the comparison group remained off work at 45 days. There was a statistically significant difference between the groups with regard to the number of days before returning to work.

Discussion and Conclusion: Education and counseling regarding pain management, physical activity, and exercise can reduce the number of days off work in people with fear-avoidance beliefs and acute low back pain.

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