The Effect of Back School Program on Fear Avoidance Behavior, Disability and Pain in Chronic Mechanic Low Back Pain

Aim: The aim of this study is to investigate the effect of back school program on pain, disability and fear avoidance belief in chronic mechanical low back pain patients. Material and Method: 54 chronic mechanical low back pain patients enrolled in the study. Pain intensity levels at rest and activity were measured by numerical rating scale. Oswestry Disability Index (ODI) was used for measuring functional disability level and Fear Avoidance Belief Questionnaire (FABQ) was for fear avoidance belief. Back school and home exercise program was performed on 28 patients in the experimental group. Control group consist of 26 patients was followed with home exercise program only. Results: No significant difference was found in terms of pain intensity, disability level and fear avoidance belief scores at initial assessment of the groups. Improvement has been identified in pain, disability level and fear avoidance scores for both groups at 3 week follow up. There was no significant difference in terms of pain intensity, disability level and fear avoidance belief scores on 3 week follow up assessment between groups (p>0,05). There was significant difference in FABQ work activity scores between groups at 3 months follow up assessment (p<0,05). When it compares to differences between 3 week and 3 months follow up assessment, there was statistically significant difference in favor of education group between ODI and FABQ scores (p< 0,001). Discussion: Back school program reduces the level of disability and fear avoidance behavior in the medium term. Our study showed that back school is not only posture and activity education program but also has an important part of the treatment on psychosocial aspects.