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

Summary In healthy participants, pain‐related fear at baseline predicted reduced lumbar flexion and perceived interference following induction of delayed‐onset muscle soreness to the lower back. ABSTRACT 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.

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