But it’ll hurt my back! Escape fear-avoidance behaviors and stay active

When you’re in pain, exercising can seem like a no-win situation. Avoiding physical activity out of fear your pain will come back or get worse is known as “fear avoidance.” This behavior is not only bad for your mental health—it can put you in a negative mindset and contribute to symptoms of depression—but it also can make your pain worse or drag out your recovery.

So, how do you escape fear avoidance? The simple answer is: Don’t avoid activities you think will bring your pain back or make it worse. The more complicated answer is: Change your mindset. Here are a few steps to help you break the vicious cycle of pain and fear-avoidance behaviors.

  1. See your doctor to make sure your pain isn’t caused by a mild or serious injury or condition. Don’t be surprised if it’s difficult to pinpoint the source of your pain. The exact source of acute low-back pain often can’t be identified. Whatever the cause, don’t let it get you down.
  2. Identify the activities that you think will make your pain come back or get worse. Make a list of the things you haven’t done in a while because you thought they might hurt. Be sure to write down why you think they might make your pain come back. Be specific. If exercising is one of those things, figure out exactly which exercises are causing the problem. Maybe it’s a certain weight, number of reps, or sets?
  3. Scale back the activities you identified to build up confidence that your body can handle some exercise without hurting. Remember, exercising in moderation can be good for pain, although it often can help to scale back your routine. Ease your way back into activity with basic core stability exercises that don’t rely on heavy weights or big movements. Once you’re confident this doesn’t bring your pain back, take a step up to slightly more intense bodyweight workouts. Over time, you might find that exercise feels good again and you can work on your foundational movement tecnhique.
  4. Stay active! Once you’ve identified activities you can do without pain and created a plan to scale back those that do, you can exercise worry free. Don’t let the fear of pain keep you stationary!

References

Booth-Kewley, S., Schmied, E. A., Highfill-McRoy, R. M., Sander, T. C., Blivin, S. J., & Garland, C. F. (2013). A prospective study of factors affecting recovery from musculoskeletal injuries. Journal of Occupational Rehabilitation, 24(2), 287–296. doi:10.1007/s10926-013-9456-7

Leeuw, M., Goossens, M. E. J. B., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. S. (2006). The Fear-Avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine, 30(1), 77–94. doi:10.1007/s10865-006-9085-0

Rainville, J., Smeets, R. J. E. M., Bendix, T., Tveito, T. H., Poiraudeau, S., & Indahl, A. J. (2011). Fear-avoidance beliefs and pain avoidance in low back pain—translating research into clinical practice. Spine Journal, 11(9), 895–903. doi:10.1016/j.spinee.2011.08.006

Roland, M. (2002). The Back Book (2nd ed.): Stationery Office Books (TSO).

Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain, 85(3), 317–332. doi:10.1016/s0304-3959(99)00242-0