title: Physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs.
abstract: OBJECTIVE
  Elevated fear-avoidance beliefs are believed to be a precursor of chronic disability, yet effective intervention options have not been described in the literature. The purpose of this case report is to describe physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs.
  
  
  METHODS
  The patient was a 42-year-old sales manager with acute low back pain. The patient had no previous history of activity-limiting low back pain and initially had limitations in straight leg raising, limitations in lumbar movement, and elevated fear-avoidance beliefs.
  
  
  METHODS
  Treatment-based classification and graded exercise were used.
  
  
  RESULTS
  Disability, fear-avoidance beliefs, and pain decreased 4 weeks after starting physical therapy. Six months later, disability and fear-avoidance beliefs had increased, but were still improved when compared with the initial measurements.
  
  
  CONCLUSIONS
  Disability and fear-avoidance beliefs improved following a fear-avoidance-based physical therapy intervention. Research is warranted to investigate the effectiveness of this approach.
authors.affiliation: Department of Physical Therapy, Brooks Center for Rehabilitation Study, University of Florida, PO Box 100154, Gainesville, FL 32610-0154, USA. sgeorge@phhp.ufl.edu
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
authors.forename: Joel E
authors.initials: JE
authors.lastname: Bialosky
authors.forename: Julie M
authors.initials: JM
authors.lastname: Fritz
mesh_terms: D000328:Adult; D003657:Decision Making; D004185:Disability Evaluation; D005081:Exercise Therapy; D005239:Fear; D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000628:therapy; D008297:Male; D026741:Physical Therapy Modalities / Q000379:methods*; D011795:Surveys and Questionnaires