Les évitements par peur dans la lombalgie aiguë (LA) .

Enquête réalisée avec le concours de 709 médecins généralistes français
et la participation de 2.727 patients (hommes majoritairement, moyenne 44 ans) atteints de LA.

Résultats : l’évitement du mouvement par peur est à la fois fréquent et précoce chez les patients atteints de LA

L'omnipraticien donnera donc les consignes nécessaires
pour surmonter le risque de chronicisation de la lombalgie.

-Fear-avoidance Beliefs About Back Pain in Patients With Acute LBP.
Original Articles

Clinical Journal of Pain. 23(8):720-725, October 2007.
Coudeyre, Emmanuel MD *; Tubach, Florence MD +; Rannou, Francois MD, PhD ++; Baron, Gabriel PhD +; Coriat, Fernand PhD [S]; Brin, Sylvie PhD [S]; Revel, Michel MD ++; Poiraudeau, Serge MD, PhD ++
Abstract:
Objective: We aimed to assess fear-avoidance beliefs in patients with acute low back pain (LBP) and to identify features of patients and general practitioners (GPs) associated with patients' fear-avoidance beliefs.

Methods: A cross-sectional study conducted in primary care practice in France. A total of 709 GPs completed a self-administered questionnaire assessing fear-avoidance beliefs [the Fear-Avoidance Beliefs Questionnaire (FABQ)] and 2727 patients with acute LBP completed a self-administered questionnaire assessing pain, perceived handicap and disability (on the Quebec Back Pain Disability Scale) and fear-avoidance beliefs (on the FABQ).

Results: Patients' FABQ mean scores were 16.8+/-5.0 for physical activities (FABQ Physical) and 19.5+/-10.9 for occupational activities (FABQ Work). From multivariate analysis, the following factors were associated with patients' FABQ Phys and Work scores: having a GP with a high rating on the FABQ Phys (P=0.0001 and 0.02 for FABQ Phys and Work, respectively), no sport practice (vs. occasional: P=0.0003 and 0.03; vs. usual/competition: P=0.0001 and 0.004), disability score (Quebec) (P=0.0001 for both FABQ scores), and pain intensity (P=0.0012 and 0.0013).

Conclusions: High levels of fear-avoidance beliefs occur early in LBP patients, and key messages on this topic should probably be delivered at a very early stage of the disease.