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ArticleEuropean journal of physical and rehabilitation medicine2025

Catastrophizing and fear avoidance beliefs in chronic low back pain: a cross-sectional study.

Julio Doménech-Fernández, Aida Ezzeddine Angulo, Lourdes Peñalver-Barrios, Eva Del Rio-González, Rocio Herrero, Azucena García-Palacios, Monica Martinez-Diaz, Iago Garreta-Catalá, Máximo A Diez-Ulloa, Rosa M Baños-Rivera

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of physical and rehabilitation medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. [Neuropsychological Risk Factors for Chronic Postoperative Pain Following Abdominal Surgery].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2026
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

10 authors.

Julio Doménech-FernándezOrthopedic Surgery Department, Clinical University of Navarra, Pamplona, Spain.
Aida Ezzeddine AnguloRehabilitation Service, General University Hospital of Valencia Consortium, Doctoral School, Catholic University of Valencia, San Vicente Mártir, Valencia, Spain - aida_ezze@hotmail.com.
Lourdes Peñalver-BarriosRehabilitation Service, Arnau de Vilanova Hospital, Valencia, Spain.
Eva Del Rio-GonzálezFaculty of Psychology, University of Zaragoza, Zaragoza, Spain.
Rocio HerreroFaculty of Psychology, University of Zaragoza, Zaragoza, Spain.
Azucena García-PalaciosCIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.
Monica Martinez-DiazRehabilitation Service, Arnau de Vilanova Hospital, Valencia, Spain.
Iago Garreta-CataláCIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.
Máximo A Diez-UlloaFaculty of Psychology, Jaime I University, Castellón, Spain.
Rosa M Baños-RiveraFaculty of Psychology, Jaime I University, Castellón, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic low back pain continues to be a challenge in everyday rehabilitation services as improvement keeps being unpredictable.

aimTo evaluate the role of pain coping strategies, fear-avoidance beliefs, anxiety and depression in pain and disability in patients with chronic low back pain.

designA cross sectional study.

settingRehabilitation and Orthopedic departments in four tertiary hospitals in Spain. POPULATION: Overall, 276 patients (200 women) with nonspecific low back pain according COST-B13 guidelines and lasting more than 6 months.

methodsPain, disability, coping strategies, catastrophizing, anxiety, depression and fear-avoidance beliefs were evaluated with validated questionnaires. Predictive associations of disability and pain were analyzed by Pearson's test and by multivariate regression.

resultsCatastrophizing is the pain coping strategy with the highest association with disability (r=0.52, P<0.01). Low back pain and disability showed little correlation in between (r=0.40, P<0.01). The correlation between fear-avoidance ideas and pain and disability was slight (r=0.20, P<0.01). No association was found between anxiety and depression with low back pain and disability. In the regression model, catastrophizing, kinesiophobia and gender explained 35% of the variance in disability. In the subanalysis of patients with surgical indication the influence of catastrophizing was maintained. However, correlation between pain and disability is lower than in patients without surgical indication.

conclusionsThe limited correlation between pain and disability suggests that pain alone cannot explain the variability of disability. Catastrophizing and kinesiophobia are predictors of the degree of disability in chronic low back pain and are cognitions potentially modifiable. CLINICAL REHABILITATION IMPACT: These results support the biopsychosocial model in the pathogenesis of chronic low back pain and support the use of cognitive behavioral therapy to modify maladaptive beliefs and attitudes as part of medical or surgical treatment in low back pain.

Indexed as

Avoidance LearningCatastrophizationChronic PainFearLow Back PainAdaptation, PsychologicalAdultAgedAnxietyCross-Sectional StudiesDepressionDisability EvaluationFemaleHumansMaleMiddle Aged

Identifiers

PMID40080029
PMCPMC12105598

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.