My 66-year old mother is seeing a physical therapist for low back pain. The therapist tells Mom to "face your pain" and "stop avoiding movement." I'm concerned that more harm than good will be done with this kind of approach. What do you think?

Confronting symptoms isn't an approach used for all patients. Studies show that fear of pain or injury is the most likely factor to predict who will move from acute LBP to chronic LBP and increased disability. For this reason patients with acute low back pain (LBP) are checked for the presence of fear avoidance beliefs (FABs).

The patient with fear-avoidance beliefs avoids movements and activities that might hurt. The result is decreased movement and decreased function. Pain intensity remains unchanged or increases. For some patients, avoiding certain positions or movement makes sense. This happens in patients who have a fracture, infection, or pressure on spinal nerves. Confrontation of symptoms won't work for this group.

More research is needed to prove no harm is done by asking patients to confront their symptoms. For now it has been given the thumbs up by researchers for use with some patients.