BACKGROUND: In LBP patients, the relationship between pain and physical activity 
remains unclear. Whereas a negative relationship between pain and self-reported 
physical activity was found, this relation disappeared in the case of overt 
behavioral data (e.g., accelerometer). Cognitive-behavioral models of the 
development of chronic pain suggest subgroups with signs of physical underuse 
and overuse.
AIMS: To examine if patients with pain-related adaptive, endurance and 
fear-avoidance coping differ in pain, self-reported physical function and overt 
physical activity 6 months after disc surgery.
METHODS: 24 patients completed questionnaires (Von Korff chronic pain grade 
(CPG), Kiel pain inventory (KPI), Funktionsfragebogen Hannover-Rücken FFbH-R) 
and underwent an 8-h accelerometer assessment in their daily life (physical 
activity level (PAL), number of constant postures (CP)). The KPI differed 
between adaptive coping (AC) (N=9), fear avoidance coping (FAC) (N=1) and 
endurance coping (EC) (N=14).
RESULTS: In the whole group, pain intensity was negative related to 
self-reported physical activity whereas PAL and CP displayed no correlation with 
pain. EC patients showed significantly higher pain scores and lower 
self-reported physical functioning compared to AC but the same level of PAL and 
furthermore, a significantly higher number of CPs in daily life. The visual 
inspection of the FAC patient revealed also high pain, low physical functioning 
and low overt physical activity.
CONCLUSIONS: The assessment of pain-related coping modes yielded an important 
differentiation between subgroups of LBP patients 6 months after surgery. 
Endurance copers displayed signs of overuse in their daily behavior in spite of 
pain than adaptive copers. The one fear avoidance coper tends to do less 
physical activity in the sense of underuse.