title: A comparison of fear-avoidance beliefs in patients with lumbar spine pain and cervical spine pain.
abstract: METHODS
  A prospective consecutive cohort study of patients with cervical spine pain and patients with lumbar spine pain referred to an academic medical center.
  
  
  OBJECTIVE
  To investigate the presence of fear-avoidance beliefs in a sample of patients with cervical spine pain and to compare the association of pain intensity, disability, and fear-avoidance beliefs in patients with cervical spine pain with that in patients with lumbar spine pain.
  
  
  BACKGROUND
  Fear-avoidance beliefs are a specific psychosocial variable involved in the development of disability from low back pain. Psychosocial variables are believed to play a role in cervical disability, but specific variables have not been investigated.
  
  
  METHODS
  Consecutive patients referred to a multidisciplinary center completed self-reports of disability, pain intensity, and fear-avoidance beliefs during an initial evaluation session. Gender, type of symptom onset, acuity, and payer source were also recorded. Associations between disability, pain intensity, and fear-avoidance beliefs were investigated in patients with cervical spine pain and patients with lumbar spine pain.
  
  
  RESULTS
  In all, 163 patients completed the self-reports and were included in this study. Weaker relations between fear-avoidance beliefs and disability were found in patients with cervical pain than in those with lumbar pain. Significant differences in fear-avoidance beliefs were found for gender, type of symptom onset, and payer source (workers' compensation, auto insurance, and traditional insurance).
  
  
  CONCLUSIONS
  The associations among fear-avoidance beliefs, pain intensity, and disability differed between patients with cervical spine pain and patients with lumbar spine pain. Fear-avoidance beliefs were significantly different in subgroups of patients.
authors.affiliation: School of Health and Rehabilitation Sciences, University of Pittsburgh, Pennsylvania, USA. georgesz@msx.upmc.edu
authors.forename: S Z
authors.initials: SZ
authors.lastname: George
authors.forename: J M
authors.initials: JM
authors.lastname: Fritz
authors.forename: R E
authors.initials: RE
authors.lastname: Erhard
mesh_terms: D000328:Adult; D001362:Avoidance Learning; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012647:Self-Assessment; D011795:Surveys and Questionnaires