The November, 2014 issue of The Spine Journal examined the role of so-called catastrophizing on chronic back pain. As the name suggests, catastrophizing is the tendency to think that things are much worse, indeed often hopeless, than they really are. I guess it is no real surprise to find out that people who engage in such thinking have more problems with back pain. This was also true of people who exhibited so-called fear-avoidance beliefs (FAB). This one is a bit more subtle that catastrophizing. People with FAB's avoid physical activities out of concern that these activities will worsen their back pain. Given the role de-conditioning plays in chronic back pain, this makes a great deal of sense. If your back pain seems to be worse than it should be and you are avoiding doing things that might help, it might be worthwhile to consider the role of catastrophizing and FAB. There is an on-line questionnaire you can take to see if you might be susceptible.