Low back pain is one of the most common and persistent health issues people face. While many assume it will go away with rest or time, studies show that two–thirds of individuals still experience lingering pain even after a year. This raises an important question: why does low back pain persist for some people but not others?

A recent study published in the European Journal of Pain sheds light on this issue, revealing a surprising link between behavior, anxiety, and pain persistence. The study explored two main activity behaviors: avoidance, which is stopping activities out of fear of pain, and persistence, which is pushing through one's pain to keep up with daily routines. Researchers found that while avoidance wasn't linked to worse outcomes, persistence behaviors were associated with higher pain levels over time.

These findings challenge the idea that “pushing through the pain” is a good strategy for recovery. Instead, the research points to a need for a more balanced, tailored approach to managing low back pain, one that addresses both physical and emotional factors.

The Study: Understanding the Link Between Behavior and Pain

The study followed 165 patients who were experiencing acute low back pain over a 12–month period. Researchers monitored their pain levels, activity behaviors, and markers of psychological distress, like anxiety. Here's what they found:

• Persistence Behavior: Participants who ignored pain and pushed through daily activities experienced a significant increase in pain intensity over time. This effect was even stronger when paired with anxiety or stress.


• Avoidance Behavior: On the other hand, avoidance (limiting activities due to fear of pain) was not found to directly increase pain levels.


• The Role of Stress: The study highlighted the importance of mental health in recovery. People who felt distressed while persisting with activity were more likely to report worsening pain.

These results are important because they show that “powering through” pain can do more harm than good in some cases, especially when emotional stress is also involved.

Why Pushing Through Pain Can Backfire

Pain is your body's way of signaling that something isn't right. Ignoring it and continuing activities like heavy lifting, repetitive bending, or prolonged sitting can overwork your muscles and put more strain on the lower back. Over time, this can lead to:

• Increased muscle tension and stiffness


• Movement control problems, where you struggle to move properly without pain


• Longer recovery times and higher risk of chronic pain

The study's findings reinforce that recovery from low back pain requires balance—not avoidance and not overactivity. Instead, it's about finding the right level of movement and activity for your body.

How Physical Therapy Can Help You Recover

Physical therapy offers a solution that aligns perfectly with these research findings. A physical therapist can help you avoid the pitfalls of both persistence and avoidance by creating a personalized recovery plan, which typically includes the following components:

• Assessing Your Movement and Pain Levels: Physical therapists can identify movement control impairments and teach you safer ways to move that reduce strain on your back.


• Guiding Your Activity Levels: By balancing movement and rest, you can stay active without overloading your lower back. This prevents pain from worsening and helps build strength over time.


• Addressing Stress and Anxiety: If psychological issues like stress and anxiety are found to be key drivers of your low back pain, your physical therapist may recommend certain interventions for alleviating stress or seeking out professional help to address these factors.

This personalized approach ensures that you recover safely and effectively without increasing your risk of long–term pain.

What This Means for You

If you're dealing with low back pain, this study should serve as a powerful reminder to listen to your body. While staying active is important, pushing through significant pain or stress can make things worse. Instead of guessing at the right approach, let a physical therapist help you find the balance you need to recover.

Contact Us Today For More Information

Struggling with low back pain? Don't let it control your life. Call our physical therapy clinic today to learn more about our services or to schedule an appointment with one of our experienced therapists.

For more information about low back pain, click here to read the full text of the study.