Acute back pain and return to work Workers with acute low back pain may be reluctant to return to return to work because they are afraid of pain and the perception of pain becomes exaggerated. Fear of pain can actually become more disabling than pain itself. A recent study in the February 2008 Physical Therapy Journal, “Effects of Education on Return-to-Work Status for People With Fear-Avoidance Beliefs and Acute Low Back Pain” examined two groups of workers who were unable to return to work following a work-related episode of low back pain and who exhibited fear-avoidance beliefs. Both groups received conventional physical therapy intervention. One group also was given education and counseling on pain management tactics and the value of physical activity and exercise. The effectiveness of the education and counseling was measured by the number of days it took people to return to work without restrictions. All participants in the education group returned to regular work duties within 45 days, whereas one-third of the other group were still off work at 45 days. The study concludes, “Education and counseling regarding pain management, physical activity, and exercise can reduce the number of days off work in people with fear-avoidance beliefs and acute low back pain.”