I'm very distressed because I hurt my back at work two weeks ago and I'm not getting better. My wife says I'm just making myself worse worrying about it. Can stress over an injury really keep me from getting better?

There is some evidence that emotional distress predicts poor recovery from acute low back pain. Distress may take the form of anxiety, depression, or somatization. Somatization is a conversion of emotional distress into physical symptoms such as headache, muscle or joint pain, or problems sleeping.

In the last few years, researchers have come up with a questionnaire to help identify patients who don't recover because of fear-avoidance beliefs (FAB). With FABs, the patient avoids movement because he or she is afraid that movement and activity will set off painful symptoms and possibly reinjure the spine.

The truth is that less movement is more likely to put the patient at risk for poor results. And distress over the situation can put the patient at further risk for disability over time.

If your doctor gives you the green light, start getting back into the swing of things. Focus on returning to your former level of activity and then take it the next step. Consider what you can do to stay active, healthy, and prevent long-term disability.

Margreth Grotle, PhD, et al. Clinical Course and Impact of Fear-Avoidance Beliefs in Low Back Pain. In Spine. August 15, 2006. Vol. 31. No. 9. Pp. 1038-1046.