Physical activity plays a key role in recovery from back pain. It is important to understand how people who have back pain make decisions about physical activity so that clinicians can provide the most useful information to patients.
Research by Ben Darlow and colleagues at the University of Otago, Wellington (NZ) explored views about activity during in-depth interviews with twelve people who had acute back pain (less than six weeks of pain) and eleven people who had chronic back pain (more than 6 months of pain). The results of this study have been published in the Archives of Physical Medicine and Rehabilitation.
The research found that participants with acute and chronic back pain made judgements about physical activity and rest using the same conceptual model. Perceived risks of activity and rest against were balanced against perceived benefits. Key risks of activity included more pain, more tissue damage or more impairment, whereas the most important benefits appeared to be psychological (like raised mood or altered focus) or social (like being with friends) rather than physical (like pain relief or strengthening). The context within which judgements were made seemed to be central to these decisions. Important contextual factors included the nature and duration of the pain, the type of physical activity, the importance of the activity, and the participant’s previous experience.
The researchers recommend that clinicians explore the positive and negative factors being considered by a patient when making decisions about activity and rest rather than labeling patients as being ‘fear-avoidant’ when they are fearful or avoid some activities. Clinicians may best support their patients to engage in physical activity by providing an informed assessment of risks and an explanation about the range of potential benefits, especially psychological and social benefits.
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