In this article, I would like to talk about lumbar spondylolisthesis and motion phobia.
Have you ever suffered from lumbar spondylolisthesis?
It is a symptom that can be the end of repetitive vigorous movements such as sports competitions in school days, but clinically, it is a case that is difficult to distinguish from chronic back pain.
Since the situation is similar to chronic low back pain, there are symptoms of pain caused by some triggers, but in the current situation, people are often instructed to do exercises within the range that does not cause pain.
There is such a thing as exercise phobia, and what does it cause? Here is a study that shows what can happen.
The study
Exercise phobia, caused by pain and low self-efficacy, seems to be associated with the prognosis of patients complaining of low back pain (LBP).
The literature highlights the potential negative impact of anatomical deficit diagnoses (e.g., lumbar spondylolisthesis) on psychological profiles.
The purpose of this study is to investigate the relationship between perceptions of spondylolisthesis, pain self-efficacy, and exercise phobia.
A secondary backward analysis was conducted.
Among 98 subjects with subacute and chronic LBP, 49 subjects diagnosed with symptomatic lumbar spondylolisthesis and 49 subjects diagnosed with non-specific LBP were included in the study.
Pain self-efficacy as measured by the Pain Self-Efficacy Questionnaire and fear of movement as measured by the Tampa Scale of Movement Phobia were considered variables to be investigated, while diagnosis and demographic/clinical variables were considered predictors or potential confounders.
By comparing the two resulting groups, the perception of spondylolisthesis had no significant effect on pain self-efficacy (p = .82) nor on fear of movement (p = .75).
Higher perceived pain caused a decrease in pain self-efficacy and an increase in kinesiophobia in both groups (p = 0.002 and p = 0,031, respectively).
Commentary
The study investigated whether people with chronic low back pain who were diagnosed with low back pain caused by "lumbar slipped disc" and those with non-specific low back pain changed psychologically and became more reluctant to exercise. The results showed that both groups were in pain.
The results showed that in both groups, the pain reduced self-efficacy and made them more reluctant to exercise.
As a patient, it may seem that "knowing the cause" has little impact on your ability to exercise, as opposed to identifying the anatomical factors.
The priority is to deal with the current "pain" rather than the cause or the exercise, and it seems that once the pain is resolved, it is time to move on to actions to avoid pain.
Some medical professionals want to find out the cause of the pain and give appropriate treatment to the cause, while others are at two extremes: they don't know the cause, but they want to be there for the patient and manage the pain.
However, it is important to know from this study that there is such a thing as kinesiophobia, and that it may interfere with exercise therapy.
Ferrari S, Striano R, Lucking E, Pillastrini P, Monticone M, Vanti C. Does the awareness of having a lumbar spondylolisthesis influence self-efficacy and kinesiophobia? A retrospective analysis. Arch Physiother. 2019;9:16. Published 2019 Dec 16. doi:10.1186/s40945-019-0070-7
Conclusion
This study has shown that people who suffer from chronic low back pain have a phobia of exercise that reduces their self-efficacy and makes them reluctant to exercise.If you are a health care provider, you should be prepared for the time when you will have to keep this in mind.
