Psychology also plays a role in physical therapy in patient recovery. The Fear Avoidance Beliefs Questionnaire (FABQ) was developed to test the patient’s beliefs about how work and activities would affect their pain. A higher FABQ score indicates more fear. A lower score indicates less fear and avoidance behaviors. Flynn (2002), and Hicks (2005) both came to the conclusion that FABQ affects recovery in patients with spinal pain. Flynn determined that a low FABQ (low fear) is a predictor of short term success in rehabilitation. Hicks (2005) determined that a high FABQ (high fear) was great at predicting failure from therapy. In other words, subjects with a high FABQ score did not recover as well.
We also have some pretty compelling evidence that your mental state affects your pain and vice versa.
Work by Curry and Wang (2004) and Lepine and Briley (2004) suggests that low back pain can cause depression and that depression can predispose people to pain. The statement the authors are making is that depression may be causing pain and not just the other way around.
Marras and Colleagues (2000) have found that certain personality types as well as psychosocial factors can influences the levels of spinal load in certain personalities. High spinal loads subject people to a great risk of spinal injury. Depending on your personality you may be more likely to experience back pain at some point in your life.
Junge A(2000) has correlated competitive anxiety with risk of injury in athletes. This sounds like a bit of a self-fulfilling prophecy. Worried about getting injured? Chances are you’re increasing your risk of injury.
Lastly and probably most scary is an article from the Washington Post from 2002 about a phenomenon called the “Nocebo Effect.” They quote research about women who believed that they were prone to heart disease to be 4 times more likely to die as women who did not have these views. Basically the nocebo effect is opposite of the placebo. People who believed they were more prone to negative health effects even though their risk was the same as everyone else were more likely to have ill health effects. Crazy huh?
This information gives us compelling evidence that our minds play an enormous role in our health. Having a positive attitude about our health appears to help speed our recovery and keep disease at bay, while a negative attitude tends to extend recovery times, cause or exacerbate pain and illness. Our fears, anxieties and personality can have an effect on our risk of injury and recovery as well.
- Your behavior and fear about an injury will decrease the likelihood of improvement as well as predict your success.
- Psychosocial stress and an introverted personality can cause increased spinal loads in subjects when performing functional tasks, increasing the susceptibility to injury.
- Having competitive anxiety increases your risk for injury. Believing you are more prone to injury or ill-health can be a self-fulfilling prophecy!
Keep a positive attitude guys!