Functional disability in nonspecific low back pain: The role of pain-related fear and problem-solving skills

Previous studies have shown that pain disability in chronic back pain patients is closely associated with pain-related fear and avoidance. This study was aimed at replicating this finding in a sample of low back pain (LBP) patients with a new episode of sick leave. In addition, the supplemental value of problem solving in predicting pain disability was examined. It was further hypothesized that problem solving would moderate the effects of daily stress on pain disability. The results were partly as predicted. Pain-related fear, pain intensity, pain catastrophizing, daily stress, and problem solving were found to be individually related to functional disability, of which pain intensity and pain catastrophizing were the strongest predictors. Problem solving neither added predictive value regarding pain disability, nor could the moderating role of problem solving be confirmed. Surprisingly, and in disagreement with previous findings, pain intensity was found to be closely related to disability in this sample of LBP patients.